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
- Trond Rasmussen, MSC1,
- Lars C. Stene, PHD1,
- Sven O. Samuelsen, PHD1,2,
- Ondrej Cinek, MD, PHD3,
- Turid Wetlesen, RN1,
- Peter A. Torjesen, PHD4 and
- Kjersti S. Rønningen, MD, PHD1
- 1Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway;
- 2Department of Mathematics, University of Oslo, Oslo, Norway;
- 3Department of Paediatrics, Motol University Hospital, Prague, Czech Republic;
- 4Hormone Laboratory, Aker University Hospital, University of Oslo, Oslo, Norway.
- Corresponding author: Trond Rasmussen, trond.rasmussen{at}fhi.no.
Abstract
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 ≥30 kg/m2 before pregnancy and maternal weight gain ≥15 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.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received April 6, 2009.
- Accepted June 30, 2009.
- © 2009 by the American Diabetes Association.
