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Bone Mass Accrual in First Six Months of Life: Impact of Maternal Diabetes, Infant Adiposity, and Cord Blood Adipokines

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Abstract

The perinatal period is a time of substantial bone mass accrual with many factors affecting long-term bone mineralization. Currently it is unclear what effect maternal gestational/type 2 diabetes has on infant bone mass accrual. This is a prospective study of offspring of Native American and Hispanic mothers with normoglycemia (n = 94) and gestational diabetes or type 2 diabetes (n = 64). Infant anthropometrics were measured at birth, 1, and 6 months of age. Cord blood leptin, high-molecular weight adiponectin (HMWA), pigment epithelium-derived factor (PEDF), vascular epithelium growth factor (VEGF), endoglin, and C-peptide were measured by ELISA. Infants had bone mineral density measurement at 1 month or/and 6 months of age using dual-energy x-ray absorptiometry scan. Mothers with diabetes were older (31 ± 6 years vs 25 ± 4 years) and had higher pre-pregnancy BMI (32.6 ± 5.8 vs 27.2 ± 6.4 kg/m2) than control mothers. Mean HbA1C of mothers with diabetes was 5.9 ± 1.0% compared to 5.1 ± 0.3% in controls early in pregnancy. Infants born to mothers with diabetes (DM-O) were born at a slightly lower gestational age compared to infants born to control mothers (Con-O). There was no difference in total body less head bone mineral content (BMC) or bone mineral density (BMD) between DM-O and Con-O. For both groups together, bone area, BMD, and BMC tracked over the first 6 months of life (r: 0.56, 0.38, and 0.48, respectively). Percent fat was strongly and positively correlated with BMC at 1 month of age (r = 0.44; p < 0.001) and BMC at both 1 and 6 months of age correlated strongly with birth weight. There were no associations between infant bone mass and cord blood leptin, PEDF, or VEGF, while C-peptide had a significant correlation with BMC at 1 and 6 months only in DM-O (p = 0.01 and 0.03, respectively). Infants born to mothers with well-controlled gestational/type 2 diabetes have normal bone mass accrual. Bone mineral content during this time is highly correlated with indices of infant growth and the association of bone mineral indices with percent body fat suggests that bone-fat crosstalk is operative early in life.

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Acknowledgements

We wish to thank study coordinators Mary Ayn Tullier, Justin Fowler, Olufolake Olufowote, and Shelly Hopper; the Choctaw Nation of Oklahoma, and the Chickasaw Nation and our study participants and families. This study was supported by NIH Grants R01 DK089034-03 (S. Chernausek, PI) and P20 MD000528-05 (T.Lyons, project PI); American Diabetes Association and Oklahoma Shared Clinical and Translational Resources (U54GM104938) with an Institutional Development Award (IDeA) from NIGMS (C. Aston). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Harold Hamm Diabetes Center, 1200, Children’s avenue Suite 4500, Oklahoma City, OK, 73104, USA

    Sowmya Krishnan, Christopher E. Aston, David A. Fields & Steven D. Chernausek

  2. Harold Hamm Diabetes Center, Oklahoma City, OK, USA

    April M. Teague

  3. Division of Endocrinology, Diabetes and Metabolic Diseases at the Medical University of South Carolina, Charleston, SC, USA

    Timothy J. Lyons

  4. Diabetes Free South Carolina, BlueCross BlueShield of South Carolina, Columbia, SC, USA

    Timothy J. Lyons

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  1. Sowmya Krishnan
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  2. Christopher E. Aston
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  3. David A. Fields
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  4. April M. Teague
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  5. Timothy J. Lyons
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  6. Steven D. Chernausek
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Correspondence to Sowmya Krishnan.

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Conflict of interest

The authors Sowmya Krishnan, Christopher E. Aston, David A. Fields, April M. Teague, Timothy J. Lyons and Steven D. Chernausek have no conflicts of interest to declare.

Ethical Approval

Signed informed consent was obtained from a parent of each infant in accordance with the University of Oklahoma Health Sciences Center, Chickasaw Nation and/or Choctaw Nation of Oklahoma institutional review boards, each of which approved the study. All clinical investigations have been conducted according to the principles expressed in the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Krishnan, S., Aston, C.E., Fields, D.A. et al. Bone Mass Accrual in First Six Months of Life: Impact of Maternal Diabetes, Infant Adiposity, and Cord Blood Adipokines. Calcif Tissue Int 111, 248–255 (2022). https://doi.org/10.1007/s00223-022-00990-0

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  • DOI: https://doi.org/10.1007/s00223-022-00990-0

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