Obesity Clinical Trial
Official title:
Maternal Gestational Diabetes in Hispanic Youth: Obesity and Insulin Resistance
Our studies are aimed at examining effects of intrauterine exposure to GDM on metabolic risks in Hispanic children. Our primary hypothesis predicts that intrauterine exposure to GDM will be associated with one or more of three critical factors involved in the development of diabetes: 1) increased adiposity, 2) insulin resistance, and 3) decreased beta cell function in Hispanic children when compared to non-exposed children matched for ethnicity, age, gender, and Tanner stage. In a subset of this cohort, we will also examine the effects of intrauterine exposure to gestational diabetes on the brain pathways that regulate appetite and body weight in children ages 6 to 15 years old.
Obesity rates have increased dramatically over the last two decades, particularly in
children. Obesity is a major risk factor for type 2 diabetes (T2D), and there is a
disproportionate prevalence of obesity and T2D in people of Hispanic origin. While a number
of factors contribute to the development of obesity and T2D there is compelling evidence
suggesting a profound role of the diabetic in utero environment. Epidemiological studies show
that exposure to maternal diabetes in utero is associated with a significant risk of
developing obesity and diabetes later in life. Provocative studies in animal models suggest
that metabolic imprinting resulting from exposure to the altered metabolic milieu of diabetes
in pregnancy leads to abnormalities in the development of specific fetal tissues, including
the hypothalamus and pancreatic islets. Based on these findings, the goal of this research is
to test the hypothesis that exposure to maternal gestational diabetes mellitus in utero
results in changes during intrauterine development that mediate increased risk for obesity
and diabetes. Through our ongoing studies on the genetics of type 2 diabetes we have access
to hundreds of Hispanic offspring of well characterized GDM and control mothers. We are,
therefore, in the unique position to perform mechanistic studies examining effects of
intrauterine exposure to GDM on metabolic risks in Hispanic children and adolescents. Our
primary hypothesis predicts that intrauterine exposure to GDM will be associated with one or
more of three critical factors involved in the development of diabetes: 1) increased
adiposity, 2) insulin resistance, and 3) decreased beta cell function in Hispanic children
when compared to non-exposed children matched for ethnicity, age, gender, and Tanner stage.
To examine the effects of exposure to GDM on brain pathways involved in the regulation of
energy homeostasis, we will perform additional functional magnetic resonance imaging (fMRI)
studies in a subset of the larger cohort.
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