{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:05:53Z","timestamp":1792202753224,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["17SFRN336101011"],"award-info":[{"award-number":["17SFRN336101011"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008333","name":"University of Alabama at Birmingham","doi-asserted-by":"publisher","award":["DK079626"],"award-info":[{"award-number":["DK079626"]}],"id":[{"id":"10.13039\/100008333","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008333","name":"University of Alabama at Birmingham","doi-asserted-by":"publisher","award":["DK056336"],"award-info":[{"award-number":["DK056336"]}],"id":[{"id":"10.13039\/100008333","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010629","name":"Fulbright Association","doi-asserted-by":"publisher","award":["PS00329197"],"award-info":[{"award-number":["PS00329197"]}],"id":[{"id":"10.13039\/100010629","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Obesity"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children born to mothers with obesity or gestational diabetes mellitus (GDM) face elevated risks of central adiposity and adverse cardiometabolic outcomes, including metabolic syndrome (MetS) and systemic inflammation. However, it remains unclear whether these risks are primarily driven by current adiposity or by in utero exposure. This study investigated associations between waist circumference (WC), waist\u2010to\u2010height ratio (WHtR), and continuous MetS (cMetS) scores in children, and evaluated whether in utero exposure to maternal obesity or GDM moderated these relationships. Associations between cMetS and cardiometabolic biomarkers were also examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children were grouped by maternal early\u2010pregnancy weight status and GDM diagnosis: (1) normal weight without GDM, (2) overweight\/obesity without GDM, and (3) overweight\/obesity with GDM. WC was classified as &lt;\u200985th or\u2009\u2265\u200985th percentile; WHtR as &lt;\u20090.5 or \u2265\u20090.5. cMetS scores were computed with and without the WC component. Group differences and associations were assessed using ANCOVA and correlation analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      WC and WHtR were strong predictors of cMetS, independent of in utero exposure group. Children with WC \u2265\u200985th percentile or WHtR \u2265\u20090.5 had significantly higher cMetS scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), even when WC was excluded from the cMetS calculation. cMetS was inversely correlated with adiponectin and positively correlated with leptin, the leptin\u2010to\u2010adiponectin ratio, HOMA\u2010IR, CRP, and IL\u20106 (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Central adiposity\u2014indexed by WC or WHtR\u2014rather than in utero exposure, is the primary driver of cardiometabolic risk. Associations between cMetS and cardiometabolic biomarkers underscore insulin resistance and adipose tissue dysfunction as key mechanisms underlying MetS in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijpo.70066","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:35:45Z","timestamp":1765373745000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Central Adiposity, Rather Than in Utero Exposure to Maternal Obesity or Gestational Diabetes, Predicts Metabolic Syndrome Risk in Children Aged 4\u201310\u2009Years"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2247-494X","authenticated-orcid":false,"given":"Daniel O.","family":"Mensah","sequence":"first","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-3402","authenticated-orcid":false,"given":"Alysha B.","family":"Everett","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia E.","family":"Fouts","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen L.","family":"Hoelscher","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha L.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica S.","family":"Bahorski","sequence":"additional","affiliation":[{"name":"College of Nursing Florida State University  Tallahassee Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla H.","family":"Mensah","sequence":"additional","affiliation":[{"name":"Sampa Government Hospital Maternity Unit  Sampa Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1333-503X","authenticated-orcid":false,"given":"Makenzie L.","family":"Callahan","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Timothy","family":"Garvey","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5253-8644","authenticated-orcid":false,"given":"Paula C.","family":"Chandler\u2010Laney","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa031049"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.09.010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2017.10.02"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-7-17"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1758-5996-2-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1808"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00989.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.49.12.2208"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.06.082"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1758-5996-4-28"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0939-4753(04)80048-6"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-018-4809-6"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2015.04.006"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms15046184"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1603"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/osp4.599"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(82)90349-0"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.45.239.13"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.44.235.291"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41387-023-00244-4"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60932-6"},{"key":"e_1_2_8_23_1","unstructured":"R. J.Kuczmarski \u201cCDC Growth Charts for the United States: Methods and Development.Department of Health and Human Services Centers for Disease Control \u201d2000."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12150"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd18.210021"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010159"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.026"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.50.11.2444"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1502821"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00591"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.11.1006"},{"issue":"5","key":"e_1_2_8_32_1","article-title":"Racial and Socioeconomic Determinants of Cardiovascular Health: A Comprehensive Review","volume":"16","author":"Borkowski P.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2013.32"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2001.19"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000060923.07573.F2"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1010112"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2006.83"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801401"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0372"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(05)70347-3"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2004.45"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2012.688195"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaf5094"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41576-021-00414-z"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-s211"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7181.427"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.02.023"},{"key":"e_1_2_8_48_1","first-page":"294","article-title":"Serum Immunoreactive Leptin Concentrations in Normal Weight and Obese Humans","volume":"834","author":"Considine R.","year":"1995","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1508-3"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"}],"container-title":["Pediatric Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijpo.70066","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijpo.70066","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijpo.70066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T23:46:11Z","timestamp":1769643971000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijpo.70066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,10]]},"references-count":49,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ijpo.70066"],"URL":"https:\/\/doi.org\/10.1111\/ijpo.70066","archive":["Portico"],"relation":{},"ISSN":["2047-6302","2047-6310"],"issn-type":[{"value":"2047-6302","type":"print"},{"value":"2047-6310","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,10]]},"assertion":[{"value":"2025-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70066"}}