1. This prospective cohort study revealed that children born to mothers with gestational diabetes mellitus (GDM) had significantly higher serum concentrations of branched-chain amino acids (BCAAs) at 6-year follow-up.
2. LDL levels were also significantly higher in offspring of GDM mothers at approximately 6 years of age.
Evidence Rating Level: 2 (Good)
The literature has established that children of mothers who experienced hyperglycemia at any point during pregnancy are at increased risk for cardiometabolic health issues and hypertension. However, the way by which this occurs is not well-studied. Some emerging literature suggests that maternal metabolomic profiles, which include amino acid (AA) concentrations, are altered in GDM and that these AA profiles also differ in offspring. AAs are also being studied in their relation to cardiovascular disease risk. The current study sought to investigate long-term impacts of GDM in mid-late pregnancy, hypothesizing that in these children, mid-childhood AA profiles and cardiometabolic risk would be increased. Women with GDM diagnosed between 26 and 28 weeks were recruited from two major hospitals between 2009 and 2010 as part of a larger study. Data were analyzed from 422 children at 6 years postpartum (mean age 6.1 years, 47.6% female). Significant differences in childhood leucine, valine and total BCAA levels were found between children of GDM and non-GDM mothers (p < .05). Children of mothers with higher fasting glucose at 26-28 weeks were more likely to have increases in plasma valine levels, and this was dose-dependent. Higher 26-28 week 2-hour glucose concentrations were associated with increased concentrations of histidine, leucine, valine, and total BCAAs in mid-childhood (ps < .05). From a cardiometabolic standpoint, the low-density lipoprotein (LDL) levels were significantly different between children of GDM and non-GDM mothers. AAs including isoleucine, leucine, valine, and total BCAAs demonstrated associations with mid-childhood cardiometabolic risks including insulin-resistance (HOMA-IR) and presence of high sensitivity C-reactive protein (hsCRP). Overall, the results of this study warrant further investigation before broad generalizations can be made, but this study does support one hypothesis for the mechanism by which GDM increases cardiometabolic risk.
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