Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity - A study of discordant sibships
Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity - A study of discordant sibships
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DOI：
10.2337/diabetes.49.12.2208
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发表时间：
2000-12-01
期刊：
影响因子：
7.7
通讯作者：
Knowler, WC
中科院分区：
文献类型：
--
作者：
Dabelea, D;Hanson, RL;Knowler, WC
子宫内暴露于糖尿病与后代的糖尿病和肥胖过度有关，但子宫内暴露的影响受到遗传因素的混淆。为了确定宫内糖尿病环境本身的作用，比较了在母亲被确认患有糖尿病之前和之后出生的兄弟姐妹的糖尿病患病率和平均BMI。核心家庭中，至少有一个兄弟姐妹出生之前，一个后，母亲被诊断为2型糖尿病被选中。因此，在此之前和之后出生的兄弟姐妹在子宫内暴露于糖尿病方面有所不同。来自19个家庭的58名兄弟姐妹中，至少有一名兄弟姐妹患有糖尿病，在相似的年龄（3年内）进行了检查。母亲患糖尿病后出生的兄弟姐妹患糖尿病的风险显著高于母亲诊断糖尿病前出生的兄弟姐妹（比值比3.7，P = 0.02）。在52个家庭中，在183名无糖尿病的兄弟姐妹中，糖尿病妊娠的后代的平均BMI比非糖尿病妊娠的后代高2.6 kg/m2（P = 0.003）。相比之下，在父亲被诊断患有糖尿病之前和之后出生的后代之间，糖尿病或BMI的风险没有显着差异。宫内暴露于糖尿病本身传递了后代患糖尿病和肥胖症的高风险，超过了仅归因于遗传因素的风险。
Intrauterine exposure to diabetes is associated with an excess of diabetes and obesity in the offspring, but the effects of intrauterine exposure are confounded by genetic factors. To determine the role of the intrauterine diabetic environment per se, the prevalence of diabetes and the mean BMI were compared in siblings born before and after their mother was recognized as having diabetes. Nuclear families in which at least one sibling was born before and one after the mother was diagnosed with type 2 diabetes were selected. Consequently, the siblings born before and after differed in their exposure to diabetes in utero. A total of 58 siblings from 19 families in which at least one sibling had diabetes were examined at similar ages (within 3 years). The risk of diabetes was significantly higher in siblings born after the mother developed diabetes than in those born before the mother's diagnosis of diabetes (odds ratio 3.7, P = 0.02). In 52 families, among 183 siblings without diabetes, the mean BMI was 2.6 kg/m(2) higher in offspring of diabetic than in offspring of nondiabetic pregnancies (P = 0.003). In contrast, there were no significant differences in risk of diabetes or BMI between offspring born before and after the father was diagnosed with diabetes. Intrauterine exposure to diabetes per se conveys a high risk for the development of diabetes and obesity in offspring in excess of risk attributable to genetic factors alone.