Effects of Maternal Surgical Weight Loss in Mothers on Intergenerational Transmission of Obesity
Notice bibliographique
Résumé
Previous studies have shown that obese women can transmit the susceptibility for obesity and its comorbidities to their offspring. Weight-loss surgery using biliopancreatic diversion (BPD) in severely obese women ameliorates type 2 diabetes, and corrects many features of the metabolic syndrome. These actions are associated with significant, long-term weight loss in these women. A pilot study showed that children born after their mother's BPD surgery had a significantly lower prevalence of obesity compared to siblings born before BDP surgery. This cross-sectional study investigated the effects of significant maternal weight loss associated with BDP surgery on the modification of obesity-related factors transmitted via the intrauterine environment and on the susceptibility of subsequent offspring to severe obesity. The study subjects were 49 mothers whose body weight loss (36% ± 1.8% body weight) had been maintained for 12 ± 0.8 years and their children aged 2.5 to 26 years born before (after maternal surgery [AMS] group, n = 57) and after (before maternal surgery [BMS] group, n = 54). Differences between the AMS and BMS groups in measures of anthropometry, and other metabolic parameters were studied. Multiple regression analysis was used to evaluate the independent contribution of individual factors. The birth weight of AMS children was lower compared to BMS children (2.9 ± 0.1 AMS vs. 3.3 ± 0.1 kg BMS, P = 0.003) and there was a reduced prevalence of macrosomia in neonates born after surgery (AMS:1.8% vs. BMS: 14.8%, P = 0.03) with no difference in underweight. In addition to these marked anthropometric changes, the following metabolic improvements were noted at follow-up in the AMS children in comparison with the BMS children. The prevalence of severe obesity was decreased 3-fold (11% vs. 35%, P = 0.004). All markers of insulin resistance, including insulin (P = 0.01), glucose (P = 0.008), and the homeostasis model assessment of insulin resistance index (P = 0.02) were decreased. The lipid profile was improved with decreases in the total cholesterol to high-density lipoprotein cholesterol ratio (P = 0.03) and increases in high-density lipoprotein cholesterol (P = 0.04). Levels of the inflammatory marker, C-reactive protein, were lower (P = 0.004). With respect to satiety-related factors, leptin was lower and ghrelin was higher (both P < 0.005). These findings demonstrate that prenatal weight control using BPD surgery in severely obese women can markedly lower the prevalence of severe obesity in AMS children through substantial reduction in several cardiometabolic markers transmitted via the intrauterine environment. This and similar interventions may have a long-term impact on the incidence of obesity in future generations.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».