The maternal and offsprings’ characteristics associated with HOMA-IR in young adults: a prospective cohort study

Diabetes is an important chronic disease. Many studies from Western countries found that both maternal environment during pregnancy and early offspring life’s factors can lead to diabetes and insulin resistance of offspring during adult life (Barker’s hypothesis). However, this data was limited in Asia. Therefore, this study was conducted to determine the predictor of diabetes in Thailand by using the surrogate markers: the homeostasis model assessment-estimated insulin resistance (HOMA-IR). The design was a prospective cohort study. First, pregnant women were recruited at first attendance at the antenatal care clinics (ANC) in our centers during 1989–1990. Various predictors were collected at subsequent ANC visits, during delivery, and 1 year after delivery. Then, in 2010, we followed up both mothers and offspring again. The characteristics of mothers and offspring which had p value < 0.2 in the univariate analysis were selected to be analyzed by multivariate analysis. There were 592 offsprings (272 males and 320 females). HOMA-IR is statistically found to be associated with the increasing of BMI, both of mother and offspring, as well as the elevated plasma triglyceride and the history of diabetes of the offspring. Interestingly, in contrast with Western reports, in-utero environment in this study in Thais did not have any significant association with HOMA-IR. Perhaps this association might be confounded by ethnic factors. Our novel finding implies that any offspring who have high BMI mother have a high chance to develop insulin resistance and perhaps diabetes in future, so they should be aware and prevent any modifiable risk factors.