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Background: We investigated the association between prenatal GDM exposure and offspring DNA methylation (DNAm) age at 3–10 years of age in the Tianjin GDM Observational Study. Methods: This study included 578 GDM and 578 non-GDM mother-child pairs. Children underwent an exam with anthropometric measurements and blood draw for DNAm analysis (Illumina 850 K array) at a median age of 5.9 years (range 3.1–10.2). DNAm age was calculated using two epigenetic clock algorithms (Horvath and Hannum). The residual resulting from regressing DNAm age on chronological age was used as a metric for age acceleration. Results: Chronological age was positively correlated with Horvath DNAm age (r = 0.53, p < 0.0001) and Hannum DNAm age (r = 0.38, p < 0.0001). Offspring age acceleration was higher in the GDM group than non-GDM group after adjustment for potential confounders (Horvath: 4.96 months higher, adjusted for sex, pre-pregnancy BMI, cell-type proportions, and technical bias, p = 0.0002; Hannum: 11.2 months higher, adjusted for cell-type proportions and technical bias, p < 0.0001). Increased offspring DNAm age acceleration was associated with increased offspring weight-for-age Z-score, BMI-for-age-Z-score, waist circumference, body fat percentage, subscapular skinfold, suprailiac skinfold, upper-arm circumference, and blood pressure; findings were stronger in the GDM group. Conclusions: We found that offspring of women with GDM exhibit accelerated epigenetic age compared to control participants, independent of other maternal factors. Epigenetic age in offspring was associated with cardiometabolic risk factors, suggesting that GDM and GDM-associated factors may have long-term effects on offspring epigenetic age and contribute to health outcomes. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to estimate the associations of genetically determined maternal blood glucose levels with obesity‐related outcomes among children from pregnancies with and without gestational diabetes mellitus (GDM). Methods: A total of 1,114 mothers with (N = 560) and without (N = 554) GDM and their children were included in the present study. A maternal genetic risk score (GRS) for blood glucose was constructed on the basis of 17 single‐nucleotide polymorphisms identified from a recent genome‐wide association study. Results: It was found that maternal GRS for blood glucose showed different associations with offspring risk of overweight and obesity, as well as adiposity measures (all Pfor interaction < 0.05). Among mothers without GDM, genetically determined maternal blood glucose levels were associated with an 89% higher risk of overweight in their children (95% CI: 42%‐152% per SD increase in GRS, P = 1.40 × 10−5) and a 120% higher risk of obesity (44%‐235%, P = 2.61 × 10−4) after adjustment for covariates. In addition, higher maternal GRS for blood glucose was associated with children's increased obesity‐related traits (all P < 0.05). However, no significant associations were observed among children of mothers with GDM. Conclusions: This study indicates that GDM status may modify the relation between genetically determined glucose levels and obesity risk among children. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between neonatal thyroid function and the formal education of mothers.Study design: Participants came from a population-based congenital hypothyroidism (CH) screening program in Tianjin, China.Methods: Of 66,390 registered births in 2015, 60,568 mothers and newborns had complete data. Mothers were categorized into one of four categories based on their educational attainment: (a) midschool or less; (b) high school or equivalent; (c) university; or (d) post graduate. Newborn thyroid-stimulating hormone (TSH) level was measured on day 3-7. Two neonatal groups were created using cutoffs of TSH > 10 μIU/ml and TSH > 20 μIU/ml. Odds ratios (OR) for CH risk by maternal education were estimated from logistic regression models after adjusting for potential confounders.Results: For TSH > 10 μIU/ml, the screen positive incidence rate for CH was 1:201 or 4.98 per 1000 births; for TSH > 20 μIU/ml, the incidence rate was 1:2222 or 0.45 per 1000 births. Screen positive incidence rates decreased with increasing maternal education level. Compared to mothers with a postgraduate education, the ORs (95% CI) for midschool or less, high school or equivalent, and university were 2.09 (1.08, 4.04), 1.45 (0.73, 2.90), and 1.61 (0.85, 3.06) using a cutoff of TSH > 10 μIU/ml. At the higher cutoff of TSH > 20 μIU/ml ORs (95% CI) for midschool or less and high school or equivalent were 3.05 (1.20,7.74) and 3.34 (1.24, 8.97), when compared to a composite reference category of university and postgraduate level education.Conclusion: Maternal education is inversely related to neonatal thyroid function though the mechanism remains unexplained. [ABSTRACT FROM AUTHOR]

Summary: Objective: Counselling patients with gestational diabetes mellitus (GDM) on their individual risk of post‐partum type 2 diabetes (T2D) is challenging. This study aimed to develop nomograms for predicting incident risk of post‐partum T2D in women with GDM diagnosed by WHO 1998 criteria. Methods: We performed a retrospective cohort study in 1263 Chinese women with GDM, of whom 83 were diagnosed as T2D at 2.3 years post‐partum. Multivariate Cox proportional hazards models were used to investigate the independent predictors for post‐partum T2D. The results of multivariate analyses were used to formulate nomograms for predicting incident risk of post‐partum T2D. The predictive accuracy was evaluated using the area under the receiver operating characteristic curve (AUROC). Results: On multivariate analysis, independent predictors of post‐partum T2DM in women with GDM included family history of diabetes [hazard ratio (HR) and its 95% confidential interval (95% CI): 2.06 (95% CI: 1.32‐3.22)], history of pregnancy‐induced hypertension [3.11 (95% CI: 1.86‐5.21)], pre‐pregnancy BMI [1.00, 1.90 (95% CI: 1.14‐3.16), and 3.67 (95% CI: 2.03‐6.63) for BMI <24, 24‐28, and ≥28 kg/m2], and 2‐hour glucose at 26‐30 gestational weeks [1.00, 2.84 (95% CI: 1.42‐5.69), and 9.42 (95% CI: 4.46‐19.90) for 2‐hour glucose at 7.8 ~ <8.5, 8.5 ~ <11.1, and ≥11.1 mmol/L). The overall AUROC of nomogram was 82.8% (95% CI: 78.1%‐87.5%), with AUROCs of 85.9% (95% CI: 79.7%‐92.1%) and 83.2% (95% CI: 77.9%‐88.6%) for post‐partum 2‐year and 3‐year risk of T2D, respectively. Conclusions: This easy‐to‐use nomogram, with non‐invasive clinical characteristics, can accurately predict the risk of post‐partum T2D in women with GDM. It may facilitate risk communication between patients and clinicians. [ABSTRACT FROM AUTHOR]

Smoking has been associated with depression in the general population. Whether passive smoking is also associated with postpartum depression (PPD) is uncertain. From 2010 to 2012, we recruited 8,842 pregnant women in Tianjin, China. The mainland Chinese version of the Edinburgh Postnatal Depression Scale was used to evaluate postpartum depressive symptoms after birth, with a score of >9 defining PPD. Data were collected using specially designed questionnaires or data from the electronic database of Tianjin Maternal and Child Health Information System. Odds ratios (OR) and 95 percent confidence intervals (CI) were obtained for the association of smoking status with PPD using binary logistic regression. Passive smoke exposure rates before and during pregnancy were 40.9 percent and 52.1 percent, respectively. A total of 8.5% (n = 747) of participants had PPD. Compared with those not exposed, women passively exposed to smoke before and during pregnancy had higher odds of PPD (before pregnancy: OR: 1.24, 95 percent CI: 1.03-1.50; during pregnancy: OR: 1.43, 95 percent CI: 1.16-1.77) after adjustment for confounding factors. Passive smoking before and during pregnancy were associated with PPD in Chinese women. Reducing passive smoke exposure may reduce PPD in Chinese women; further longitudinal studies are warranted to replicate these findings. [ABSTRACT FROM AUTHOR]

Postpartum depression is associated with adverse consequences for mother and offspring. The heritable ABO blood group has been associated with multiple diseases, including mental illness and diabetes. We explored the association of ABO blood group and postpartum depressive symptoms (PPDS) in a population-based cohort of pregnant Chinese women. From 2010 to August 2012, we recruited 8842 pregnant women with a mean age of 28.5 years (SD: 2.94) and mean body mass index of 22.4kg/m2 (SD: 3.45) in Tianjin, China. We used the Mainland Chinese version of the Edinburgh Postnatal Depression Scale after delivery with a cutoff score of 10 to define PPDS. Odds ratios (ORs) and 95% confidence intervals (CIs) for PPDS were obtained using binary logistic regression. Of 8842 women, 8.5% (n = 747) developed PPDS. Compared to those with blood group B, women with blood groups A, AB or O had a higher odds of PPDS (adjusted ORs: 1.23 (95% CI: 1.13-1.40), 1.31 (95% CI: 0.98-1.74), and 1.30(95% CI:1.03-1.60), respectively). Blood group B was associated with reduced odds of PPDS in pregnant Chinese women. If replicated in other studies, non-blood group B may be a useful risk factors for PPDS in Chinese pregnant women. [ABSTRACT FROM AUTHOR]

Aims: To assess the association of uric acid (UA) with the risks of postpartum type 2 diabetes and prediabetes among women with prior gestational diabetes mellitus (GDM).Methods: We performed a cross-sectional study of 1262 GDM women at 1-5 years after delivery using the baseline data from the Tianjin Gestational Diabetes Mellitus Prevention Program. Logistic regression models were used to estimate the association of different levels of serum UA with the risks of type 2 diabetes and prediabetes.Results: The multivariable-adjusted odds ratios (ORs) across quartiles of serum UA were 1.00, 1.23 (95% confidence interval [CI] 0.55-2.78), 2.05 (95% CI 0.96-4.39), and 3.17 (95% CI 1.54-6.55) (Ptrend < 0.001) for type 2 diabetes, and 1.00, 1.50 (95% CI 1.03-2.19), 2.28 (95% CI 1.58-3.30), and 2.88 (95% CI 1.99-4.17) (Ptrend < 0.001) for prediabetes, respectively. Restricted cubic splines models showed positive linear associations of serum UA as a continuous variable with the risks of type 2 diabetes and prediabetes. This positive association was significant when stratified by healthy weight and overweight participants.Conclusions: Serum UA levels have a graded positive association with the risks of type 2 diabetes and prediabetes among Chinese with a history of GDM. [ABSTRACT FROM AUTHOR]

The cases were a pair of siblings with a carnitine palmitoyltransferase (CPT2) deficiency detected by tandem mass spectrometry. Their C16 and C18:1 levels were both within the normal range, while C0 was low, and the (C16+C18:1)/C2 ratio was high. Following genetic testing, a novel CPT2 gene mutation was identified in both patients. The male patient had a normal growth rate during 5 years of follow-up after treatment. By contrast, the female patient did not take l -carnitine supplements and died after an infectious disease-associated illness when she was 1 year old. These data emphasize the need to raise awareness about CPT2 deficiency so as to correctly diagnose and accurately manage the disease. [ABSTRACT FROM AUTHOR]