Evidence mapPaperPMID 41634175Full record

ArticleDiabetologia2026

Maternal and fetal genetic predispositions to insulin deficiency and resistance affect fetal growth through distinct pathways.

Gechang Yu, Claudia H T Tam, Mai Shi, Alice E Hughes, Chuiguo Huang, Yuzhi Deng, Michael N Weedon, Cadmon K P Lim, Chi Chiu Wang, Juliana C N Chan and 5 more

Abstract read
In one paragraph

Article in Diabetologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Gechang YuDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Claudia H T TamDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Mai ShiDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Alice E HughesDepartment of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK.
Chuiguo HuangDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Yuzhi DengDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Michael N WeedonDepartment of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK.
Cadmon K P LimDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Chi Chiu WangDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.
Juliana C N ChanDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Wing Hung TamDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.
William LoweDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Rachel M FreathyDepartment of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK.
Richard A OramDepartment of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK.
Ronald C W MaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. rcwma@cuhk.edu.hk.ORCID http://orcid.org/0000-0002-2795-714X

Funding

General Research Fund of the Research Grants Council of the Hong Kong SAR, China 14102719General Research Fund of the Research Grants Council of the Hong Kong SAR, China 14118718General Research Fund of the Research Grants Council of the Hong Kong SAR, China 471713General Research Fund of the Research Grants Council of the Hong Kong SAR, China CUHK 473408National Institute of Child Health and Human Development R01-HD34242NHGRI NIH HHS HG-004415NIDDK NIH HHS R01-HD34243Research Grants Council Research Impact Fund R4012-18the RGC Area of Excellence Scheme AoE/M-401/24-RWellcome Senior Research Fellowship WT220390Wellcome Trust WT220390
6 · The paper itself

Abstract

aims/hypothesisWe aimed to investigate whether maternal and fetal genetic predispositions to insulin deficiency and resistance affect offspring fetal growth through distinct pathways in multi-ethnic populations.

methodsIn 5065 multi-ethnic mother-infant pairs, we examined the conditional associations of maternal and fetal partitioned polygenic risk scores (pPRSs) for type 2 diabetes-related pathways with fetal growth outcomes, including birthweight, sum of skinfold thicknesses (SSF), large-for-gestational-age (LGA) births and small-for-gestational-age (SGA) births. Two-sample Mendelian randomisation (2SMR) in Europeans was performed for triangulation. Exposures were eight type 2 diabetes-related pathways (n=1,812,017), eight beta cell function indices (n=26,356) and two insulin sensitivity indices (n=53,657). Outcomes were maternal and fetal genetically determined birthweight (n=406,063). Mediation analysis was used to assess the mediation effects of maternal glucose levels and BMI on maternal genetic effects and of cord blood C-peptide on fetal genetic effects. Co-localisation analyses were performed to test for shared causal variants.

resultsFetal type 2 diabetes polygenic risk score (PRS) and pPRSs for lipodystrophy-related insulin resistance and impaired fasting glucose (IFG)-related insulin deficiency were associated with lower birthweight and SSF, while maternal type 2 diabetes PRS and pPRSs for IFG-related insulin deficiency and obesity-related insulin resistance were associated with higher offspring birthweight, SSF and LGA. These associations were consistent across five ethnic groups. Maternal post-load hyperglycaemia mediated 44.2% and 34.2% of the effects of type 2 diabetes PRS and IFG pPRS, respectively, while maternal BMI mediated 43.4% of the effect of Obesity pPRS. 2SMR found consistent results in Europeans and further revealed that fetal insulin sensitivity index and corrected insulin response were associated with higher birthweight. Some loci with shared causal variants acted through multiple pathways, including CDKAL1, TCF7L2, ADCY5 and MACF1. CONCLUSIONS/

interpretationReduced fetal growth may be driven by lipodystrophy-related insulin resistance and IFG-related insulin deficiency pathways. Targeting pregnant women with high type 2 diabetes PRS/pPRS and prescribing interventions to reduce their post-load hyperglycaemia and BMI may help reduce offspring risk of LGA.

Indexed as

Fetal DevelopmentGenetic Predisposition to DiseaseInsulinInsulin ResistanceAdultBirth WeightDevelopmental Origins of Health and DiseaseDiabetes Mellitus, Type 2FemaleGenetic Risk ScoreHumansInfant, Large for Gestational AgeInfant, NewbornPregnancyInsulinFetal growthInsulin deficiencyInsulin resistanceMendelian randomisationMulti-ethnic populationsPartitioned polygenic risk scoresType 2 diabetes

Identifiers

PMID41634175
PMCPMC13236813

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.