Maternal BMI Before Pregnancy, Maternal Weight Gain During Pregnancy, and Risk of Persistent Positivity for Multiple Diabetes-Associated Autoantibodies in Children With the High-Risk HLA Genotype: The MIDIA study

• Published in: Diabetes care Vol. 32; no. 10; pp. 1904 - 1906
• Main Authors: Rasmussen, Trond, Stene, Lars C, Samuelsen, Sven O, Cinek, Ondrej, Wetlesen, Turid, Torjesen, Peter A, Rønningen, Kjersti S
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.10.2009
• Subjects: Autoantibodies; Autoantibodies - immunology; Autoimmunity; Biological and medical sciences; Birth order; Body Mass Index; Children & youth; Diabetes; Diabetes Mellitus - genetics; Diabetes Mellitus - immunology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Genetic aspects; Genotype; Genotype & phenotype; Gestational Age; HLA Antigens - genetics; HLA-DQ Antigens - genetics; HLA-DR3 Antigen - genetics; HLA-DR4 Antigen - genetics; Humans; Infant, Newborn; Insulin - immunology; Measurement errors; Medical sciences; Metabolic diseases; Miscellaneous; Obesity; Original Research; Pregnancy; Pregnant women; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Receptor-Like Protein Tyrosine Phosphatases, Class 8 - immunology; Studies; Type 1 diabetes; Weight Gain - physiology; Endocrinopathy; Autoimmunity; Human; High risk; HLA-System; Multiple; Antibody; Diabetes mellitus; Body weight; Major histocompatibility system; Autoantibody; Corporal biometry; Weight gain; Pregnancy; Body mass index; Association; Mother; Risk factor; Female; Woman; Child
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc09-0663

OBJECTIVE: To assess whether maternal BMI before pregnancy and weight gain during pregnancy predicted the risk of islet autoimmunity in genetically susceptible children. RESEARCH DESIGN AND METHODS: Of 46,939 newborns screened for the high-risk HLA genotype DR4-DQ8/DR3-DQ2, 1,003 were positive and 885 were followed with serial blood samples tested for autoantibodies to insulin, GAD, and insulinoma-associated protein 2 (IA2). The end point was defined as repeated positivity for two or three autoantibodies or the onset of type 1 diabetes (islet autoimmunity). RESULTS: Thirty-six children developed islet autoimmunity, of whom 10 developed type 1 diabetes. Both maternal BMI greater-than-or-equal30 kg/m² before pregnancy and maternal weight gain greater-than-or-equal15 kg predicted the increased risk of islet autoimmunity (hazard ratio [HR] 2.5, P = 0.023, and HR 2.5, P = 0.015, respectively), independent of maternal diabetes. CONCLUSIONS: Maternal weight may predict risk of islet autoimmunity in offspring with a high genetic susceptibility for type 1 diabetes.