Intrauterine diabetes exposure and the risk of renal disease in diabetic Pima Indians
Intrauterine diabetes exposure and the risk of renal disease in diabetic Pima Indians
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DOI：
10.2337/diabetes.47.9.1489
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发表时间：
1998-09-01
期刊：
影响因子：
7.7
通讯作者：
Bennett, PH
中科院分区：
文献类型：
--
作者：
Nelson, RG;Morgenstern, H;Bennett, PH
本文对503例2型糖尿病皮马印第安人的宫内环境与肾脏疾病的关系进行了横断面研究。研究对象是从亚利桑那州吉拉河印第安人社区正在进行的糖尿病及其并发症研究的参与者中选择的。作为研究的一部分，通过定期检查确定了受试者在子宫内接触糖尿病的情况。在非糖尿病母亲的后代中，尿白蛋白排泄（UAE）（白蛋白与肌酐比值大于或等于30mg /g）升高的发生率为40%(83 / 207)，在糖尿病前期母亲（即怀孕时未患糖尿病但怀孕后患糖尿病的妇女）的后代中为43%(105 / 246)，在怀孕期间患有糖尿病的母亲的后代中为58%（29 / 50）。在对年龄、性别、糖尿病病程、HbA（1c）和后代平均动脉压进行控制后，采用广义估计方程进行logistic回归分析，发现妊娠期孕妇糖尿病与UAE升高密切相关。怀孕期间患有糖尿病的母亲的后代阿联酋升高的几率是糖尿病前期母亲后代的3.8倍（95% CI 1.7-8.4）；非糖尿病母亲和糖尿病前期母亲的后代UAE升高的几率相似（优势比为0.94;95% CI 0.59-1.5）。我们的结论是，暴露于糖尿病宫内环境会增加糖尿病皮马印第安人UAE升高的风险。这种暴露的影响似乎独立于导致糖尿病肾病的其他易感因素。
The association between the diabetic intrauterine environment and renal disease was examined cross-sectionally in 503 Pima Indians with type 2 diabetes. Subjects were selected from participants in an ongoing study of diabetes and its complications in the Gila River Indian Community of Arizona. Subjects' exposure to diabetes in utero was established from periodic examinations conducted as part of the study. The prevalence of elevated urinary albumin excretion (UAE) (albumin-to-creatinine ratio greater than or equal to 30 mg/g) was 40% (83 of 207) in the offspring of nondiabetic mothers, 43% (105 of 246) in the offspring of prediabetic mothers (i.e., women who were not diabetic at the time of the pregnancy but who developed diabetes after the pregnancy), and 58% (29 of 50) in the offspring of mothers who had diabetes during pregnancy. After controlling for age, sex, duration of diabetes, HbA(1c), and mean arterial pressure in the offspring in a logistic regression analysis using generalized estimating equations, maternal diabetes during pregnancy was strongly associated with elevated UAE. The odds of elevated UAE in the offspring of mothers who had diabetes during pregnancy was 3.8 times (95% CI 1.7-8.4) that of the offspring of prediabetic mothers; the odds of elevated UAE in the offspring of nondiabetic and prediabetic mothers were similar (odds ratio of 0.94; 95% CI 0.59-1.5). We concluded that exposure to a diabetic intrauterine environment increases the risk of elevated UAE in diabetic Pima Indians. The effect of this exposure appears to be independent of other susceptibility factors that lead to nephropathy in diabetes.