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Effects of Maternal Surgical Weight Loss in Mothers on Intergenerational Transmission of Obesity
Abstract
BACKGROUND AND OBJECTIVES: By studying cardiometabolic risk factors in children born after maternal biliopancreatic diversion bariatric surgery (AMS) compared with those in children born before maternal surgery (BMS), we tested the hypothesis that significant maternal weight loss may modify obesity-related factors transmitted via the intrauterine environment. DESIGN: Anthropometry and fasting blood levels were studied in 49 mothers who had lost 36 +/- 1.8% body weight sustained for 12 +/- 0.8 yr and their 111 children (54 BMS and 57 AMS) aged 2.5-26 yr. RESULTS: AMS children had lower birth weight (2.9 +/- 0.1 AMS vs. 3.3 +/- 0.1 kg BMS, P = 0.003) associated with a reduced prevalence of macrosomia (1.8 AMS vs. 14.8% BMS, P = 0.03) with no difference in underweight. At the time of follow-up, AMS children exhibited 3-fold lower prevalence of severe obesity (11 vs. 35%, P = 0.004), greater insulin sensitivity (homeostasis model assessment of insulin resistance index 3.4 +/- 0.3 vs. 4.8 +/- 0.5, P = 0.02), improved lipid profile (cholesterol/high-density lipoprotein cholesterol 2.96 +/- 0.11 vs 3.40 +/- 0.18, P = 0.03; high-density lipoprotein cholesterol 1.50 +/- 0.05 vs. 1.35 +/- 0.05 mmol/liter, P = 0.04), lower C-reactive protein (0.88 +/- 0.17 vs. 2.00 +/- 0.34 microg/ml, P = 0.004), and leptin (11.5 +/- 1.5 vs.19.7 +/- 2.5 ng/ml, P = 0.005) and increased ghrelin (1.28 +/- 0.06 vs.1.03 +/- 0.06 ng/ml, P = 0.005) than BMS offspring (AMS vs. BMS, respectively, for all). CONCLUSIONS: This unique study of children aged 2.5-26 yr born before and after maternal antiobesity surgery demonstrated improvements in cardiometabolic markers sustained into adolescence, attributable to an improved intrauterine environment.
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“Compelling evidence showing a role for developmental programming rather than genetic factors in the maternal transmission of obesity comes from studies of women who have undergone bariatric surgery to reduce weight; siblings born of women post surgery displayed a reduced prevalence of obesity compared to those born before surgery [86, 87].”
From Developmental programming of offspring adipose tissue biology and obesity risk (2021) · cites this paper as [86]
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Metadata
- Authors
- Smith, J., Cianflone, K., Biron, S., Hould, F. S., Lebel, S., Marceau, S., Lescelleur, O., Biertho, L., Simard, S., Kral, J. G., & Marceau, P.
- Affiliations
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Université Laval (CA)
- SUNY Downstate Health Sciences University (US)
- Corresponding author
- Marceau, P.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-11-01
- Volume
- 94
- Issue
- 11
- Pages
- 4275-4283
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1996374391
- Cited by
- 354
- References
- 36
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 13 · 2023: 19 · 2022: 16 · 2021: 22 · 2020: 23 · 2019: 24 · 2018: 19 · 2017: 16 · 2016: 24 · 2015: 29 · 2014: 34 · 2013: 32 · 2012: 31
- FWCI
- 23.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (MOP64446)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- biliopancreatic diversion, maternal weight loss, intergenerational transmission of obesity, offspring obesity, intrauterine environment, birth weight, macrosomia, insulin sensitivity, cardiometabolic risk factors, leptin, ghrelin, C-reactive protein, lipid profile, childhood obesity prevention
- MeSH terms
- Birth Weight, Cross-Sectional Studies, Female, Fetal Macrosomia, Follow-Up Studies, Humans, Infant, Low Birth Weight, Infant, Newborn, Obesity, Pregnancy, Uterus, Weight Loss, Body Size, Bariatric Surgery
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