Influence of placental and peripheral malaria exposure in fetal life on cardiometabolic traits in adult offspring
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Date
2022-03-13
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open Diabetes Research and Care
Abstract
Introduction Fetal malaria exposure may lead to
intrauterine growth restriction and increase the risk
of developing diabetes and cardiovascular diseases in
adulthood. We investigated the extent to which fetal
peripheral and placental malaria exposure impacts
insulin sensitivity and secretion, body composition and
cardiometabolic health 20 years after in utero malaria
exposure.
Research design and methods We traced 101 men
and women in Muheza district, Tanga region whose
mothers participated in a malaria chemosuppression
during a pregnancy study in 1989–1992. All potential
participants were screened for malaria, hepatitis B and HIV
to ascertain study eligibility. Seventy-six individuals (44
men, 32 women) were included in this cohort study. The
participants underwent a thorough clinical examination
including anthropometric measurements, ultrasound
scanning for abdominal fat distribution, blood pressure,
75 g oral glucose tolerance test, an intravenous glucose
tolerance test followed by a hyperinsulinemic euglycemic
clamp and a submaximal exercise test.
Results Offspring exposed to placental malaria during
pregnancy had significantly higher 30-minute plasma
post-glucose load levels, but no significant difference in
peripheral insulin resistance, insulin secretion or other
cardiometabolic traits compared with non-exposed
individuals.
Conclusions Using the state-of- the- art euglycemic clamp
technique, we were unable to prove our a priori primary
hypothesis of peripheral insulin resistance in young adult
offspring of pregnancies affected by malaria. However, the
subtle elevations of plasma glucose might represent an
early risk marker for later development of type 2 diabetes
if combined with aging and a more obesogenic living
environment.
Description
Keywords
Placental, Peripheral malaria, Cardiometabolic traits
Citation
Grunnet, L.G., Bygbjerg, I.C., Mutabingwa, T.K., Lajeunesse-Trempe, F., Nielsen, J., Schmiegelow, C., Vaag, A.A., Ramaiya, K. and Christensen, D.L., 2022. Influence of placental and peripheral malaria exposure in fetal life on cardiometabolic traits in adult offspring. BMJ Open Diabetes Research and Care, 10(2), p.e002639.