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Intrauterine exposure to gestational diabetes mellitus (GDM) is associated with an increased risk for adverse metabolic and cognitive outcomes, but the mechanisms are not clear. We tested the hypothesis that exposure to GDM is associated with changes in adiposity and brain trajectories during childhood to adolescence. Participants were 204 children (110 GDM exposed; 94 unexposed; 61% female; age 7-11 at baseline). Children underwent brain MRIs up to 4 times over 6 years. Adiposity measurements were obtained yearly over 6 years. Adiposity measures and FreeSurfer-derived brain volumes were compared between GDM-exposed and unexposed groups using mixed-effect models. We observed significant non-linear trajectories of BMI, body fat %, and waist circumference by age (all adjusted for sex and pubertal stage, p0.0001) across all children. BMI (p=.058), body fat% (p.049), and waist circumference (p.015) trajectories varied by GDM exposure, with higher adiposity markers for GDM exposed vs unexposed. Compared to unexposed children, children exposed to GDM before 26 weeks had increased growth of total cortex (p.009) and grey matter volume (p.009), adjusted for age, sex, and pubertal stage, and multiple comparisons. Intrauterine exposure to GDM affects both adiposity and brain trajectories in transitioning from childhood to adolescence. These findings suggest a mechanistic link between GDM exposure and risk for adverse metabolic and neural outcomes. Disclosure S.P. Chakravartti: None. X. Gao: None. A. Xiang: None. K.A. Page: None. Funding American Diabetes Association (1-14-ACE 36); 1F31DK137584-01A1, R01DK116858, R01DK134079
CHAKRAVARTTI et al. (Fri,) studied this question.