Central Adiposity, Rather Than in Utero Exposure to Maternal Obesity or Gestational Diabetes, Predicts Metabolic Syndrome Risk in Children Aged 4-10 Years.

Waist circumference and waist-to-height ratio were strong predictors of continuous metabolic syndrome scores, independent of in utero exposure group.

• Children with WC ≥ 85th percentile or WHtR ≥ 0.5 had significantly higher cMetS scores (p < 0.0001).
• The association remained significant even when WC was excluded from the cMetS calculation, indicating the relationship was not an artifact of shared measurement.
• Children were grouped by maternal early-pregnancy weight status and GDM diagnosis: (1) normal weight without GDM, (2) overweight/obesity without GDM, and (3) overweight/obesity with GDM.
• Group differences and associations were assessed using ANCOVA and correlation analyses.

In utero exposure to maternal obesity or gestational diabetes did not moderate the relationship between central adiposity measures and continuous metabolic syndrome scores.

• Three maternal exposure groups were compared: normal weight without GDM, overweight/obesity without GDM, and overweight/obesity with GDM.
• WC and WHtR predicted cMetS independently of which in utero exposure group the child belonged to.
• The study population consisted of children aged 4–10 years.
• The authors concluded that current adiposity, rather than prenatal exposure, is the primary driver of cardiometabolic risk.

Continuous metabolic syndrome scores were inversely correlated with adiponectin and positively correlated with multiple cardiometabolic biomarkers.

• cMetS was inversely correlated with adiponectin (p < 0.01).
• cMetS was positively correlated with leptin, the leptin-to-adiponectin ratio, HOMA-IR, CRP, and IL-6 (all p < 0.01).
• These associations underscore insulin resistance and adipose tissue dysfunction as key mechanisms underlying MetS in children.
• The leptin-to-adiponectin ratio was specifically highlighted as a biomarker of adipose tissue dysfunction.

Children born to mothers with obesity or gestational diabetes mellitus face elevated risks of central adiposity and adverse cardiometabolic outcomes including metabolic syndrome and systemic inflammation.

• This background premise motivated the study's investigation of whether these risks are primarily driven by current adiposity or by in utero exposure.
• The study examined both metabolic syndrome risk and systemic inflammation as cardiometabolic outcomes.
• Biomarkers assessed included adiponectin, leptin, leptin-to-adiponectin ratio, HOMA-IR, CRP, and IL-6.

Waist circumference was classified using the 85th percentile threshold and waist-to-height ratio using a cutoff of 0.5 for assessment of central adiposity in children.

• WC was classified as < 85th or ≥ 85th percentile.
• WHtR was classified as < 0.5 or ≥ 0.5.
• cMetS scores were computed both with and without the WC component to avoid circularity in the central adiposity–MetS association.
• The study sample included children aged 4–10 years.