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Sex-dependent associations of maternal androgen levels with offspring BMI and weight trajectory from birth to early childhood

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Abstract

Context

In preclinical studies, high androgen levels during pregnancy are associated with low birth weight and rapid postnatal weight gain in the offspring. However, human data linking prenatal androgens with birth weight and early life weight gain in the offspring are scarce.

Design

We evaluated 516 mother–child pairs enrolled in the New England birth cohorts of the Collaborative Perinatal Project (1959–1966). We assayed androgen bioactivity in maternal sera during third-trimester using a receptor-mediated luciferase expression bioassay. Age and sex-specific BMI Z-scores (BMIz), defined using established standards, were assessed at birth, 4 months, 1 year, 4 years, and 7 years. We used linear mixed models to evaluate the relation of maternal androgens with childhood BMIz overall and by sex. We examined the association of maternal androgens with fetal growth restriction. The association of weight trajectories with maternal androgens was examined using multinomial logistic regression.

Results

Higher maternal androgen levels associated with lower BMIz at birth (β = − 0.39, 95% CI: − 0.73, − 0.06); this relation was sex-dependent, such that maternal androgens significantly associated with BMIz at birth in girls alone (β = − 0.72, 95% CI: − 1.40, − 0.04). The relation of maternal androgens with fetal growth restriction revealed dose threshold effects that differed by sex. There was no significant association between maternal androgens and weight trajectory overall. However, we found a significant sex interaction (p = 0.01); higher maternal androgen levels associated with accelerated catch-up growth in boys (aOR = 2.14, 95% CI: 1.14, 4.03).

Conclusion

Our findings provide evidence that maternal androgens may have differential effects on the programming of intrauterine growth and postnatal weight gain depending on fetal sex.

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Acknowledgements

We thank Anne Remington for help with project management. We also thank Nancy Gee at U.C. Davis with Dr. Lasley’s laboratory for performing the bioactive androgen assays for this study.

Funding

National Institute of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) K08 HL132122-02 (Huang, PI); State of Arizona Arizona Biomedical Research Commission (ABRC) ADHS14-00003606 (Handa/Goldstein, PIs), NIMH-NHLBI R01MH074679 (Goldstein, PI), NIA RC2AG036666 (Loucks and Buka, PIs), and NIA R01AG023397 (Buka, PI). Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Gilman).

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Authors and Affiliations

  1. Section of Men’s Health, Aging and Metabolism, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    G. Huang & S. Bhasin

  2. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    S. A. Aroner & J. M. Goldstein

  3. Center for Clinical Investigation, Brigham and Women’s Hospital, Boston, MA, USA

    C. P. Bay

  4. Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA

    S. E. Gilman

  5. Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, NY, USA

    A. Ghassabian

  6. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    E. B. Loucks & S. L. Buka

  7. Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA

    R. J. Handa

  8. Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ, USA

    R. J. Handa

  9. Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA

    B. L. Lasley

  10. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    J. M. Goldstein

  11. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    S. E. Gilman

  12. Department of Obstetrics and Gynecology, School of Medicine, Center for Health and the Environment, University of California Davis, Davis, CA, USA

    B. L. Lasley

  13. Center for Health and the Environment, University of California, Davis, CA, USA

    B. L. Lasley

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  1. G. Huang
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  2. S. A. Aroner
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  4. S. E. Gilman
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  5. A. Ghassabian
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  6. E. B. Loucks
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  7. S. L. Buka
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  8. R. J. Handa
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  9. B. L. Lasley
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  10. S. Bhasin
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  11. J. M. Goldstein
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Correspondence to G. Huang.

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Shalender Bhasin (SB) has received research grant support from Abbvie Pharmaceuticals, Transition Therapeutics, and Metro International Biotechnology, LLC for investigator-initiated research unrelated to this study. SB has served as a consultant to AbbVie and Novartis. SB has a financial interest in Function Promoting Therapies, LLC, a company aiming to develop innovative solutions that enhance precision and accuracy in clinical decision-making and facilitate personalized therapeutic choices in reproductive health. SB’s interests were reviewed and are managed by Brigham and Women’s Hospital and Partners HealthCare in accordance with their conflict of interest policies. Dr. Goldstein is on the scientific advisory board for and has equity in Cala Health. However, this study has no relationship to the work in Cala Health. The rest of the authors have no conflicts of interest to disclose.

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The study protocol was approved by the institutional review boards at Partners HealthCare system and Brown University.

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All participants provided written informed consent.

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Huang, G., Aroner, S., Bay, C. et al. Sex-dependent associations of maternal androgen levels with offspring BMI and weight trajectory from birth to early childhood. J Endocrinol Invest 44, 851–863 (2021). https://doi.org/10.1007/s40618-020-01385-4

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  • DOI: https://doi.org/10.1007/s40618-020-01385-4

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