2165-P: Gestational Diabetes and Maternal Obesity Show Differential Associations with Childhood Fat Distribution

Introduction and Objective: Prenatal exposure to GDM and maternal obesity are risk factors for offspring metabolic disease, but their independent effects on fat distribution remain unclear. We examined whether GDM and maternal pre-pregnancy BMI (mpBMI) differentially influence abdominal fat depots beyond overall adiposity. Methods: 45 children (mean age 11.3±1.2 yrs; 27 girls; 25 GDM-exposed; mpBMI range 19.2-49.3 kg/m2) had measures of total body fat % (% BF), and abdominal MRI to quantify visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (ASAT). Data were log transformed as needed. General linear models tested associations of GDM exposure and mpBMI (per 5-unit increase) with VAT, ASAT, and % BF, adjusting sequentially for age, sex, alternate prenatal exposure, % BF, and all covariates. Results: GDM exposure was associated with higher VAT (β=0.46, p=0.04) and marginal ASAT (β=0.36, p=0.12); slightly attenuated after mpBMI adjustment (VAT: β=0.39, p=0.07; ASAT: β=0.28, p=0.21). Associations persisted after adjusting for % BF (VAT: β=0.23, p=0.05; ASAT: β=0.15, p=0.06), and all covariates (VAT: β=0.21, p=0.07; ASAT: β=0.135, p=0.08). GDM exposure was not associated with child total BF % (β=1.18, p=0.74). mpBMI was associated with VAT and ASAT (VAT: β=0.17, p=0.02; ASAT: β=0.19, p=0.01), persisting after GDM adjustment (VAT: β=0.15, p=0.04; ASAT: β=0.17, p=0.02), but attenuated after child % BF adjustment (VAT: β=0.039, p=0.30; ASAT: β=0.031, p=0.23) and all covariates (VAT: β=0.028, p=0.46; ASAT: β=0.024, p=0.35). mpBMI was associated with child total BF % (β=2.49, p=0.03). Conclusion: GDM exposure was associated with greater visceral adiposity independent of overall adiposity, suggesting a mechanism for metabolic risk. Maternal obesity may also contribute to metabolic risk, but this is likely explained by the child's overall adiposity. Disclosure K. Le: None. E.C. Morgan: None. T. Chow: None. J. Alves: None. B. Belcher: None. A. Xiang: None. K. Page: None. Funding American Diabetes Association (1-14-ACE-36), NIH (RO1DK116858, R01DK134079)