Maternal insulin resistance and maternal β-cell function during pregnancy for offspring overweight before 2 years of age among women with gestational diabetes

Objective: To explore associations of maternal insulin resistance and beta-cell dysfunction with offspring overweight before 24 months of age among children of Chinese women with gestational diabetes mellitus (GDM). Methods: Offspring of women with GDM (n = 901) who were enrolled in a lifestyle trial during pregnancy were followed up to 24 months of age in Tianjin, China. Restricted cubic spline analysis was performed to examine full-range associations of maternal homeostatic model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-%beta) with childhood overweight. Logistic regression was performed to obtain the odds ratios (ORs) and 95% confidence interval (CI) of maternal high HOMA-IR and low HOMA-%beta at diagnosis of GDM for offspring overweight within 12 months of age and at 13-24 months of age. Results: Maternal high HOMA-IR was associated with an increased risk of offspring being overweight within 12 months of age and at 13-24 months of age (OR: 1.71, 95%CI: 1.12-2.62 & 1.89, 1.13-3.17, respectively). Maternal low HOMA-%beta was associated with an increased risk of offspring being overweight at 13-24 months of age (1.64, 1.05-2.55). Conclusions: Both maternal increased insulin resistance and decreased beta-cell function at diagnosis of GDM were associated with elevated risk of offspring overweight in early childhood among Chinese women with GDM.