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Preconception insulin resistance and neonatal birth weight in women with obesity: role of bile acids.

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. 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. Electronic address: sdszgaoshanshan@163.com. 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.

Reproductive biomedicine online. 2021;(5):931-939
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Abstract

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.

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Publication Type : Randomized Controlled Trial

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