Endocrine Abstracts

Introduction: Offspring of mothers with diabetes have greater risk of adverse metabolic outcome in later life. Increased adiposity is a plausible mediator. We performed a meta-analysis of studies examining adiposity in infants and children in relation to maternal diabetes.

Methods: Citations were identified in PubMed and authors contacted for additional data. Fat free mass, fat mass, body fat %, and skinfold thickness were compared in offspring of mothers with and without diabetes. Random effects analysis was used.

Results: 23 studies examining 20 000 infants and 14 studies of 16 000 children were included. The majority of studies examined newborn infants within 72 h and the mean (S.D.) age of children was 8.1 (3.7) years.

Infants of mothers with diabetes had higher fat mass (83 g (49, 117); P<0.00001), body fat % (2.2% (1.1, 3.2); P<0.0001), triceps (0.52 mm (0.37, 0.68)), and subscapular skinfold thickness (0.81 mm (0.56, 1.05); P<0.00001) than infants of mothers without diabetes, but high study heterogeneity was apparent. Fat free mass was similar (−11 g (−99, 77); P=0.81).

Children of mothers with diabetes had higher fat mass (1.69 kg (0.96, 2.43); P<0.00001), fat free mass (0.58 kg (0.10, 1.06); P=0.02), body fat % (2.3% (1.0, 3.7); P=0.0008), triceps (1.2 mm (0.3, 2.2); P=0.01), and subscapular skinfold thickness (1.6 mm (0.6, 2.6); P=0.001) than children of mothers without diabetes.

Similar results were seen in the subgroup analysis of maternal gestational diabetes but insufficient data of types 1 and 2 diabetes were provided.

Conclusion: Infants and children of mothers with diabetes appear to have greater adiposity than offspring of mothers without diabetes, displaying 20–30% greater fat mass. Persistence or amplification of adiposity in adult life may explain the increased risk of type 2 diabetes in offspring of mothers with diabetes.