A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: the DALI randomised controlled trial.

Autor: van Poppel MNM; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. Mireille.van-poppel@uni-graz.at.; Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria. Mireille.van-poppel@uni-graz.at., Simmons D; Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia.; Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK., Devlieger R; Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium.; Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium., van Assche FA; Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium.; Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium., Jans G; Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium.; Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium., Galjaard S; Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium.; Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.; Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands., Corcoy R; Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; Centro de Investigación Biomédica en Red (CIBER) Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain., Adelantado JM; Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Dunne F; Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland.; College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland., Harreiter J; Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria., Kautzky-Willer A; Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria., Damm P; Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Mathiesen ER; Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Jensen DM; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.; Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Andersen LL; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.; Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Tanvig M; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.; Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.; Region of Southern Denmark, Denmark., Lapolla A; Dipartimento di Medicina, Università Degli Studi di Padova, Padua, Italy., Dalfra MG; Dipartimento di Medicina, Università Degli Studi di Padova, Padua, Italy., Bertolotto A; Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Wender-Ozegowska E; Medical Faculty I, Poznań University of Medical Sciences, Poznań, Poland., Zawiejska A; Medical Faculty I, Poznań University of Medical Sciences, Poznań, Poland., Hill D; Recherche en Santé Lawson SA, Bronschhofen, Switzerland., Snoek FJ; Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands., Jelsma JGM; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands., Desoye G; Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.
Jazyk: angličtina
Zdroj: Diabetologia [Diabetologia] 2019 Jun; Vol. 62 (6), pp. 915-925. Date of Electronic Publication: 2019 Mar 06.
DOI: 10.1007/s00125-019-4842-0
Abstrakt: Aims/hypothesis: Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity.
Methods: In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DALI) lifestyle trial, 436 women with a BMI ≥29 kg/m 2 were randomly assigned to counselling on healthy eating (HE), physical activity (PA) or HE&PA, or to usual care (UC). In secondary analyses of the lifestyle trial, intervention effects on neonatal outcomes (head, abdominal, arm and leg circumferences and skinfold thicknesses, estimated fat mass, fat percentage, fat-free mass and cord blood leptin) were assessed using multilevel regression analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed.
Results: Outcomes were available from 334 neonates. A reduction in sum of skinfolds (-1.8 mm; 95% CI -3.5, -0.2; p = 0.03), fat mass (-63 g; 95% CI -124, -2; p = 0.04), fat percentage (-1.2%; 95% CI -2.4%, -0.04%; p = 0.04) and leptin (-3.80 μg/l; 95% CI -7.15, -0.45; p = 0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (-5.79 μg/l; 95% CI -11.43, -0.14; p = 0.05) compared with UC. Reduced sedentary time, but not gestational weight gain, mediated intervention effects on leptin in both the HE&PA and PA groups.
Conclusions/interpretation: The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary time seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity and diabetes risk of the offspring need to be elucidated.
Trial Registration: ISRCTN70595832.
Databáze: MEDLINE
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