Postprandial Triglycerides Predict Newborn Fat More Strongly than Glucose in Women with Obesity in Early Pregnancy
Linda A Barbour1,2, Sarah S Farabi1, Jacob E Friedman1,3
1Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Insights
Maternal obesity is linked to higher newborn body fat. Early pregnancy postprandial triglycerides (PPTGs) in obese mothers strongly correlate with infant body fat, suggesting a new intervention target.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Metabolism
- Pediatric Obesity Research
Background:
- Maternal obesity is a primary driver of large-for-gestational-age infants and childhood obesity.
- Newborn body fat percentage is a strong predictor of later childhood obesity.
- While maternal glucose is studied, the role of fasting and postprandial triglycerides (PPTGs) in pregnancy and their link to newborn adiposity remains largely unexplored.
Purpose of the Study:
- To investigate whether fasting and postprandial triglycerides (PPTGs) are elevated in pregnant women with obesity (OB) compared to normal weight (NW) women.
- To determine if fasting TGs and PPTGs correlate more strongly with newborn percent fat (NB%fat) than maternal glucose.
- To explore the relationship between maternal TGs and dietary chylomicron metabolism.
Main Methods:
- Prospective study measuring fasting and postprandial triglycerides (TGs), free fatty acids, glucose, and insulin over 4 hours post-breakfast.
- Measurements were taken twice during pregnancy (early: 14-16 weeks; later: 26-28 weeks) in 27 normal weight (NW) and 27 obese (OB) mothers.
- Newborn body fat percentage (NB%fat) was assessed using dual x-ray absorptiometry.
Main Results:
- Mothers with OB exhibited significantly higher fasting and postprandial triglycerides (PPTGs) from early pregnancy (≥30% increase at 14-16 weeks, P < 0.001).
- In mothers with OB, 1-hour (r=0.71) and 2-hour (r=0.69) PPTGs at 14-16 weeks showed the strongest correlation with NB%fat.
- For mothers with NW, the change in TGs from early to later pregnancy correlated most strongly with NB%fat (r=0.57). Maternal glucose levels did not significantly improve prediction models.
Conclusions:
- Elevated postprandial triglycerides (PPTGs) in early pregnancy are a significant finding in mothers with obesity.
- Early pregnancy 1- or 2-hour PPTGs demonstrate a strong association with newborn adiposity.
- These findings highlight PPTGs as a potential early intervention target to mitigate excess newborn adiposity and reduce the risk of childhood obesity.
Objective:
Maternal obesity (OB) accounts for the majority of large-for-gestational-age infants, and newborn percent fat (NB%fat) correlates strongest with childhood OB. In addition to maternal glucose, fasting triglycerides (TGs) may contribute, but postprandial triglycerides (PPTGs) are unstudied. It was hypothesized that fasting TGs and PPTGs are higher in women with OB compared with women with normal weight (NW) throughout pregnancy, correlate more strongly with NB%fat than glucose, and may relate to dietary chylomicron TGs.
Methods:
Fasting TGs and PPTGs, free fatty acids, glucose, and insulin were prospectively measured 10 times over 4 hours after a controlled liquid breakfast early (14-16 weeks) and later (26-28 weeks) in pregnancy in 27 mothers with NW and 27 with OB. NB%fat was measured by dual x-ray absorptometry.
Results:
Fasting TGs and PPTGs were already ≥ 30% higher in mothers with OB at 14 to 16 weeks (P < 0.001) versus mothers with NW. In mothers with OB, a simple 1-hour (r = 0.71; P < 0.01) or 2-hour (r = 0.69; P < 0.01) PPTG at 14 to 16 weeks correlated strongest with NB%fat. In mothers with NW, the increase in TGs from early to later pregnancy correlated strongest with NB%fat (r = 0.57; P < 0.01). Maternal glucose did not statistically add to prediction models.
Conclusions:
These novel data suggest that 1- or 2-hour PPTGs might be a new target for early intervention in pregnancies with OB to prevent excess newborn adiposity and attenuate child OB risk.
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