Diabetes risk factors in childhood: new insights Restricted; Files Only
Beyh, Yara (Summer 2024)
Abstract
Type 2 diabetes (T2DM) is rapidly increasing in the pediatric population and expressing as an aggressive disease. Most studies investigating possible T2DM risk factors focus on adolescents and adults, leaving little insight on the risk factors of the disease in pre-pubertal children. The aim of this dissertation is to examine the signals of diabetes in childhood considering factors from the three major players of the developmental origin of health and disease (DOHaD) hypothesis. Hence, we examined the role of each of 1) exposure to prenatal stress, 2) maternal pre-pregnancy weight, 3) growth trajectories, 4) adipokines, 5) child sex, and 6) phthalates, in the development of hyperglycemia and insulin resistance by the age of 8 years. We further examine whether child sex, maternal pre-pregnancy weight, and prenatal exposure to phthalates influence any of the observed associations. We examined these associations in nearly 1,000 maternal-child dyads from the Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) study from Mexico City, Mexico – a longitudinal study conducted between 2007-2010. First, we did not observe any association between prenatal stress exposure and hyperglycemia in the child. Second, having a ‘high’ growth trajectory is associated with higher insulin levels and increased risk of insulin resistance. Third, at the longitudinal level, adipokines are not associated with glycemia or insulin resistance, however, cross-sectionally, leptin is associated with higher insulin and risk of insulin resistance. Fourth, higher maternal pre-pregnancy weight increases the risk of elevated glucose levels at the age of 8 years when exposed to prenatal stress. Fifth, child sex has no effect on the observed associations. Finally, prenatal exposure to a mixture of high molecular weight (HMW) phthalates lowers the chance of elevated glucose at the age of 8 years and modifies the associations of growth and adipokines with glycemia at the age of 8 years. The main findings from this body of research warrant further investigation to inform recommendations for preventing the development of diabetes in younger children.
Table of Contents
Chapter 1 Introduction. 1
Chapter 2 Background. 9
Chapter 3 Overview of Methods. 33
Chapter 4 Association between prenatal exposure to stress and hyperglycemia in children at 8 years of age: the PROGRESS cohort of Mexico. 44
Chapter 5 Association between growth trajectories and glycemia in children at eight years of age: the PROGRESS cohort of Mexico. 77
Chapter 6 Association between adipokines and glycemia in children under age 8: the PROGRESS cohort of Mexico. 109
Chapter 7 Exposure to prenatal phthalates shows slight effect on the simultaneous association of growth trajectories and adipokines with glycemia in Mexican children at the age of 8 years. 138
Chapter 8 Discussion and Next Steps. 163
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File download under embargo until 21 August 2026 | 2024-06-25 01:09:20 -0400 | File download under embargo until 21 August 2026 |
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