Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus.
Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus.
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DOI：
10.2337/dc08-0039
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发表时间：
2008-09
期刊：
影响因子：
16.2
通讯作者：
Herrera E
中科院分区：
文献类型：
--
作者：
Schaefer-Graf UM;Graf K;Kulbacka I;Kjos SL;Dudenhausen J;Vetter K;Herrera E
明确妊娠期糖尿病（GDM）孕妇血糖和血脂对宫内代谢环境和胎儿生长的影响。研究设计和方法-在150例妊娠中，在妊娠晚期测定了母体血清和脐带血中的血清甘油三酯（TG）、胆固醇、游离脂肪酸（FFA）、甘油、胰岛素和葡萄糖。母体葡萄糖值来自口服葡萄糖耐量试验和葡萄糖曲线。胎儿腹围（AC）的测量同时进行了母亲的血液采样和出生体重，体重指数和新生儿的脂肪质量获得后交付。母体TG和FFA与胎儿AC大小相关（28周：甘油三酯，P = 0.001; FFA，P = 0.02），分娩时与所有新生儿人体测量指标相关（FFA：出生体重，P = 0.002; BMI，P = 0.001;脂肪量，P = 0.01）。调整混杂变量后，母体FFA和TG在分娩时仍然是与大于胎龄儿（LGA）独立相关的唯一参数（分别为P = 0.008和P = 0.04）。LGA新生儿母亲的FFA水平高于适合胎龄（阿加）新生儿母亲（362.8 ± 101.7 vs. 252.4 ± 10.1，P = 0.002）。分娩时母亲的TG、FFA和甘油水平与脐带血中的水平相关（分别为P = 0.003、P = 0.004和P = 0.005）。胎儿甘油三酯和胆固醇水平与新生儿出生体重（P = 0.001）、BMI（P = 0.004）和脂肪量（P = 0.001）呈负相关。与阿加或LGA新生儿相比，小于胎龄儿（SGA）的TG显著更高，而LGA新生儿的胰岛素/葡萄糖比值和FFA最高。结论：在控制良好的GDM妊娠中，母体血脂是胎儿血脂和胎儿生长的强预测因子。与正常生长的婴儿相比，异常生长的婴儿似乎暴露于不同的宫内环境。
OBJECTIVE—To determine the contribution of maternal glucose and lipids to intrauterine metabolic environment and fetal growth in pregnancies with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS—In 150 pregnancies, serum triglycerides (TGs), cholesterol, free fatty acids (FFAs), glycerol, insulin, and glucose were determined in maternal serum and cord blood during the 3rd trimester. Maternal glucose values came from oral glucose tolerance testing and glucose profiles. Measurements of fetal abdominal circumference (AC) were performed simultaneously with maternal blood sampling and birth weight, and BMI and neonatal fat mass were obtained following delivery. RESULTS—Maternal TGs and FFAs correlated with fetal AC size (at 28 weeks: triglycerides, P = 0.001; FFAs, P = 0.02), and at delivery they correlated with all neonatal anthropometric measures (FFA: birth weight, P = 0.002; BMI, P = 0.001; fat mass, P = 0.01). After adjustment for confounding variables, maternal FFAs and TGs at delivery remained the only parameters independently related to newborns large for gestational age (LGA) (P = 0.008 and P = 0.04, respectively). Maternal FFA levels were higher in mothers with LGA newborns than in those with appropriate for gestational age (AGA) newborns (362.8 ± 101.7 vs. 252.4 ± 10.1, P = 0.002). Maternal levels of TGs, FFAs, and glycerol at delivery correlated with those in cord blood (P = 0.003, P = 0.004, and P = 0.005, respectively). Fetal triglyceride and cholesterol levels were negatively correlated with newborn birth weight (P = 0.001), BMI (P = 0.004), and fat mass (P = 0.001). TGs were significantly higher in small for gestational age (SGA) newborns compared with AGA or LGA newborns, while insulin-to-glucose ratio and FFAs were the highest in LGA newborns. CONCLUSIONS—In well-controlled GDM pregnancies, maternal lipids are strong predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared with those with appropriate growth.
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DOI：
10.1159/000014190
发表时间：
2000-01-01
期刊：
BIOLOGY OF THE NEONATE
影响因子：
--
作者：
Merzouk, H;Meghelli-Bouchenak, M;Belleville, J
通讯作者：
Belleville, J
影响因子：
16.2
作者：
NOLAN, CJ;RILEY, SF;BEISCHER, NA
通讯作者：
BEISCHER, NA
影响因子：
3.5
作者：
Di Cianni, G;Miccoli, R;Del Prato, S
通讯作者：
Del Prato, S
影响因子：
5.8
作者：
CUMMINGS, SW;HATLEY, W;OHASHI, M
通讯作者：
OHASHI, M
DOI：
10.1067/mlc.2000.111004
发表时间：
2000-12-01
期刊：
JOURNAL OF LABORATORY AND CLINICAL MEDICINE
影响因子：
--
作者：
Merzouk, H;Madani, S;Belleville, J
通讯作者：
Belleville, J