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Offspring\u2019s metabolic and adiposity traits were assessed at 18 years postpartum. Associations were evaluated using multiple linear regression and logistic regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among the 506 mother\u2013child pairs followed up to 18 years, maternal fasting plasma glucose (FPG) in pregnancy was positively associated with offspring\u2019s FPG (\u03b2 = 0.06 [95% CI 0.02, 0.09]), while maternal 1 h plasma glucose (PG) showed a positive association with offspring\u2019s FPG (\u03b2 = 0.05), 30 min PG (\u03b2 = 0.21) and 2 h PG (\u03b2 = 0.14). All maternal glycaemic levels were associated with an increased risk of offspring being overweight\/obese, particularly maternal 1 h PG (OR 1.50 [95% CI 1.17, 1.93]). Offspring of mothers with gestational diabetes mellitus showed a higher prevalence of abnormal glucose tolerance (11.86% vs 7.97%), impaired fasting glucose (1.89% vs 0.49%) and impaired glucose tolerance (10.34% vs 7.13%) than offspring of mothers with normal glucose tolerance, although these associations did not reach statistical significance in fully adjusted models, underscoring the benefit of considering maternal glucose as a continuous trait.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\/interpretation<\/jats:title>\n            <jats:p>Maternal glucose levels in pregnancy showed a long-term association with offspring\u2019s metabolic health into young adulthood, with continuous associations across the full maternal glucose spectrum, suggesting a graded effect of maternal hyperglycaemia on offspring\u2019s metabolic risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00125-025-06476-6","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T17:41:50Z","timestamp":1751478110000},"page":"2205-2216","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Association between maternal glucose levels in pregnancy and offspring\u2019s metabolism and adiposity: an 18-year birth cohort study"],"prefix":"10.1007","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-5970","authenticated-orcid":false,"given":"Yuzhi","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6076-7703","authenticated-orcid":false,"given":"Hanbin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4186-7113","authenticated-orcid":false,"given":"Noel Y. 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Y. Deng acknowledges support from the Hong Kong PhD Fellowship Scheme. Some of the data were presented at the International Diabetes Epidemiology Group (IDEG) 2025 Symposium (oral presentation on Saturday 5 April 2025, Bangkok, Thailand) and the International Diabetes Federation World Diabetes Congress 2025 (oral poster presented on 9 April 2025, Bangkok, Thailand).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"Data collected for the study will not be made available to others.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"Research Grants Council (RGC) General Research Fund (ref. 14102719) and partial support from the Health and Medical Research Fund (ref. 18190741). The funding sources did not play any role in the study design, the interpretation of the study or the decision to publish the results.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Ronald C. W. Ma is a member of the editorial board of Diabetologia.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"YD conceptualised the study, performed formal analysis, used software, created visualisations and wrote the original draft. HW and NN contributed to the conceptualisation, methodology, investigation and manuscript review. CT contributed to the conceptualisation, methodology, validation and manuscript review. AT and MC contributed to the conceptualisation, investigation and manuscript review. KL contributed to the methodology, investigation and manuscript review. CW, WT and RM co-led the conceptualisation and investigation, provided resources and reviewed and edited the manuscript. WT led the funding acquisition. RM led the analysis, contributed to the original draft and reviewed and edited the manuscript. RM is the guarantor of this work, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}