Preconception insulin resistance and neonatal birth weight in women with obesity: role of bile acids,Reproductive BioMedicine Online

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Preconception insulin resistance and neonatal birth weight in women with obesity: role of bile acids
Reproductive BioMedicine Online ( IF 4 ) Pub Date : 2021-08-11 , DOI: 10.1016/j.rbmo.2021.08.005
Zheng Wang ₁ , Ruxandra A Nagy ₂ , Henk Groen ₃ , Astrid E P Cantineau ₁ , Anne M van Oers ₁ , Lotte van Dammen ₄ , Vincent Wekker ₅ , Tessa J Roseboom ₅ , Ben W J Mol ₆ , Uwe J F Tietge ₇ , Annemieke Hoek ₁ ,

Affiliation

University of Groningen, University Medical Centre Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands.
University of Groningen, University Medical Centre Groningen, Department of Clinical Genetics, Groningen, The Netherlands.
University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Groningen, The Netherlands.
University of Groningen, University Medical Centre Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands; University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Groningen, The Netherlands; Iowa State University, Department of Human Development and Family Studies, Ames Iowa, USA.
Academic Medical Centre, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam, The Netherlands; Amsterdam Public Health research institute, Academic Medical Centre, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, the Netherlands.
Monash University, Department of Obstetrics and Gynecology, Clayton, Australia.
Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden.

Research question

Does maternal preconception insulin resistance affect neonatal birth weight among women with obesity? Is insulin resistance associated with circulating bile acids? Do bile acids influence the association between maternal preconception insulin resistance and neonatal birth weight?

Design

An exploratory post-hoc analysis of the LIFEstyle randomized controlled trial comparing lifestyle intervention with conventional infertility treatment in women with a BMI of ≥29 kg/m². Fasting blood samples were collected at randomization and after 3 and 6 months in 469 women. Insulin resistance was quantified using the homeostasis model assessment of insulin resistance (HOMA-IR). Bile acid sub-species were determined by liquid chromatography with tandem mass spectrometry. Singletons were included (n = 238). Birth weight Z-scores were adjusted for age, offspring gender and parity. Multilevel analysis and linear regressions were used.

Results

A total of 913 pairs of simultaneous preconception HOMA-IR (median [Q25; Q75]: 2.96 [2.07; 4.16]) and total bile acid measurements (1.79 [1.10; 2.94]) µmol/l were taken. Preconception HOMA-IR was positively associated with total bile acids (adjusted B 0.15; 95% CI 0.09 to 0.22; P < 0.001) and all bile acid sub-species. At the last measurement before pregnancy, HOMA-IR (2.71 [1.91; 3.74]) was positively related to birth weight Z-score (mean ± SD 0.4 ± 1.1; adjusted B 0.08; 95% CI 0.01 to 0.14; P = 0.03). None of the preconception bile acids measured were associated with birth weight.

Conclusion

Maternal preconception insulin resistance is an important determinant of neonatal birth weight in women with obesity, whereas preconception bile acids are not.

中文翻译：

肥胖女性孕前胰岛素抵抗和新生儿出生体重：胆汁酸的作用

研究问题

孕前胰岛素抵抗是否会影响肥胖女性的新生儿出生体重？胰岛素抵抗与循环胆汁酸有关吗？胆汁酸会影响孕前胰岛素抵抗与新生儿出生体重之间的关系吗？

设计

一项 LIFEstyle 随机对照试验的探索性事后分析，比较了 BMI ≥ 29 kg/m ²女性的生活方式干预与常规不孕症治疗。469 名女性在 3 个月和 6 个月后随机收集空腹血样。使用胰岛素抵抗的稳态模型评估 (HOMA-IR) 对胰岛素抵抗进行量化。通过液相色谱和串联质谱法测定胆汁酸亚种。包括单身人士（n  = 238）。出生体重 Z 分数根据年龄、后代性别和胎次进行了调整。使用多级分析和线性回归。

结果

共进行了 913 对同时孕前 HOMA-IR（中位数 [Q25；Q75]：2.96 [2.07；4.16]）和总胆汁酸测量值（1.79 [1.10；2.94]）μmol/l。孕前 HOMA-IR 与总胆汁酸（调整后的 B 0.15；95% CI 0.09 至 0.22；P < 0.001）和所有胆汁酸亚种呈正相关。在怀孕前的最后一次测量中，HOMA-IR (2.71 [1.91; 3.74]) 与出生体重 Z 评分呈正相关（平均值 ± SD 0.4 ± 1.1；调整后的 B 0.08；95% CI 0.01 至 0.14；P  = 0.03） . 测量的孕前胆汁酸均与出生体重无关。