Intrauterine exposure to diabetes is a determinant of hemoglobin A1c and systolic blood pressure in Pima Indian children
Intrauterine exposure to diabetes is a determinant of hemoglobin A1c and systolic blood pressure in Pima Indian children
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DOI：
10.1210/jc.2005-0007
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发表时间：
2005-06-01
影响因子：
5.8
通讯作者：
Salbe, AD
中科院分区：
文献类型：
--
作者：
Bunt, JC;Tataranni, PA;Salbe, AD
背景/目的：鉴于儿童肥胖和2型糖尿病（T2DM）的发病率都在上升，我们调查了妊娠期间母亲的糖尿病状况是否是儿童时期后代发生T2DM或心血管疾病相关危险因素的决定因素。设计/参与者：42名皮马印第安人，年龄7 - 11岁，从母亲口服葡萄糖耐量试验中回顾性确定为糖尿病妊娠的后代（22名ODM， 8名男性，14名女性）或在母亲患糖尿病之前出生的后代（20名PRE， 12名男性，8名女性）。背景/主要结局测量：在住院临床研究单位测量体重、身高、体重指数、体脂百分比、血压和空腹血糖、胰岛素、血红蛋白A1c （HbA1c）、总胆固醇、甘油三酯和高密度脂蛋白-胆固醇浓度，并在横断面分析中进行比较。结果：调整年龄和性别后，ODM的HbA1c浓度（ODM = 5.7 +/- 0.4, PRE = 5.0 +/- 0.4%, P = 0.002）、收缩压（ODM = 118 +/- 13, PRE = 107 +/- 10 mm Hg, P = 0.02）、高密度脂蛋白浓度（ODM = 41 +/- 9, PRE = 48 +/- 6 mg/dl, P = 0.03）均显著高于PRE。妊娠期孕妇糖尿病状况是决定收缩压（β = 7.50, P = 0.03）和糖化血红蛋白（β = 0.43, P = 0.002）的重要因素，与年龄、性别和体脂百分比无关。结论：宫内暴露于糖尿病是儿童时期收缩压和HbA1c升高的重要决定因素，与肥胖和2型糖尿病的遗传易感性无关。这些数据表明，子宫内暴露于糖尿病会增加日后发展为2型糖尿病和/或心血管疾病的独立风险。
Context/Objective: Given the increasing rates of both childhood obesity and type 2 diabetes (T2DM), we investigated whether maternal diabetes status during pregnancy is a determinant of risk factors associated with T2DM or cardiovascular disease in offspring during childhood.Design/Participants: Forty-two Pima Indians, aged 7 - 11 yr, were identified retrospectively from maternal oral glucose tolerance tests as offspring of a diabetic pregnancy ( 22 ODM, eight males, 14 females) or offspring born before the mother developed diabetes ( 20 PRE, 12 males, eight females).Setting/Main Outcome Measures: Weight, height, body mass index, percent body fat, blood pressure, and fasting concentrations of glucose, insulin, hemoglobin A1c (HbA1c), total cholesterol, triglycerides, and high-density lipoprotein-cholesterol were measured while staying in an in-patient clinical research unit and compared in cross-sectional analyses.Results: After adjustment for age and gender, ODM had significantly higher concentrations of HbA1c ( ODM = 5.7 +/- 0.4, PRE = 5.0 +/- 0.4%, P = 0.002), higher systolic (SBP) blood pressure ( ODM = 118 +/- 13, PRE = 107 +/- 10 mm Hg; P = 0.02), and lower concentrations of high-density lipoprotein ( ODM = 41 +/- 9, PRE = 48 +/- 6 mg/dl, P = 0.03) than PRE. Maternal diabetes status during pregnancy persisted as a significant determinant of SBP ( beta = 7.50, P = 0.03) and HbA1c ( beta = 0.43, P = 0.002), independent of age, gender, and percent body fat.Conclusion: Intrauterine exposure to diabetes is a significant determinant of higher SBP and HbA1c during childhood, independent of adiposity and a genetic predisposition to T2DM. These data suggest that in utero exposure to diabetes confers an additional independent risk for the development of T2DM and/or cardiovascular disease later in life.