Hyperglycemia and Pregnancy Outcome(HAPO)Follow Up Study

高血糖与妊娠结局（HAPO）随访研究

• 批准号: 8456907
• 负责人: BOYD E METZGER
• 金额: $ 432.58万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-15 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8456907
• 关键词: Address; Age; American; Birth; Birth Weight; Blinded; Blood Glucose; Blood Pressure; C-Peptide; Caregivers; Child; Childhood; Consensus; Data; Data Collection; Diabetes Mellitus; Diabetic mother; Diagnosis; Diagnostic; Dyslipidemias; Elderly; Ethnic group; Fatty acid glycerol esters; Follow-Up Studies; Frequencies; Gestational Diabetes; Glucose; Glucose Metabolism Disorders; Guidelines; Human Resources; Hyperglycemia; Hyperinsulinism; Hypertension; Impaired fasting glycaemia; Infant; Inflammation; International; Laboratories; Lipids; Measures; Metabolic Diseases; Mothers; Nature; Neonatal; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Observational Study; Outcome; Outcome Study; Overweight; Participant; Phenotype; Positioning Attribute; Pregnancy; Pregnancy Outcome; Pregnancy Trimesters; Pregnancy in Diabetics; Protocols documentation; Race; Recommendation; Recruitment Activity; Resources; Risk; Risk Factors; Serum; Sum; Third Pregnancy Trimester; Training; Woman; abdominal fat; adverse outcome; aged; base; cardiovascular risk factor; cohort; follow-up; glucose tolerance; impaired glucose tolerance; instrument; insulin secretion; insulin sensitivity; obesity in children; obesity risk; offspring; public health relevance

DESCRIPTION (provided by applicant): Offspring of mothers with pre-existing diabetes mellitus (DM) or gestational DM (GDM) have an increased risk of childhood obesity. GDM is also associated with an increased maternal risk of type 2 DM. What is not known is the risk of childhood obesity and metabolic disorders or maternal disorders of glucose metabolism along the continuum of maternal glucose to levels diagnostic of DM. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study will recruit from the cohort of women and their offspring who participated in the HAPO Study to address these questions. Its hypothesis is hyperglycemia in pregnancy, less severe than overt DM, is independently associated with increased risk of adverse childhood and maternal outcomes 8-12 years later. HAPO, an observational study, examined glucose tolerance in a large, multi-national, racially diverse cohort of women in the 3rd trimester of gestation using a common protocol and data collection instruments, uniform training of personnel and a central laboratory. HAPO's hypothesis was hyperglycemia in pregnancy, less severe than overt diabetes, is independently associated with increased risk of adverse maternal and neonatal outcomes. Its results led a consensus panel to formulate new International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for the diagnosis of GDM. In HAPO, higher levels of maternal glucose were independently associated with increased frequency of birthweight, cord serum C- peptide, and infant adiposity >90th percentile. In the offspring of diabetic mothers, these outcomes are risk factors for childhood obesity and metabolic disorders, but the nature of these associations and magnitude of risk associated with increasing levels of maternal glucose below those diagnostic of diabetes, including mothers with GDM based upon the new IADPSG criteria, are not known. A HAPO Follow-Up Study is uniquely positioned to address these important questions. Its General Aim is to obtain measures of adiposity, glucose, insulin sensitivity and secretion, lipids, inflammation and blood pressure (BP) in 7,000 HAPO mother-offspring (aged 8-12) pairs of multiple ethnic/race groups in 10 of the 15 HAPO field centers. The primary aims and hypotheses are: Primary Aim 1: To determine associations of maternal glucose levels during pregnancy with measures of adiposity in offspring. Hypothesis 1: Maternal glucose levels, including those newly classified as GDM, are positively and independently associated with measures of adiposity in offspring (obesity, overweight, percent fat). Primary Aim 2: Determine associations of maternal glucose levels during pregnancy and maternal metabolic disorders 8-12 years later. Hypothesis 2: Maternal glucose levels, including those newly classified as GDM, are positively and independently associated with later maternal risk of disorders of glucose metabolism (diabetes, impaired fasting glucose, impaired glucose tolerance). Secondary aims will examine associations of maternal glucose levels during pregnancy with glycemia and insulin sensitivity and secretion, lipids, BP and inflammation in the offspring and measures of cardiovascular risk in the mothers.

描述（由申请人提供）：母亲既往患有糖尿病（DM）或妊娠期糖尿病（GDM）的后代患儿童肥胖的风险增加。GDM还与母亲患2型糖尿病的风险增加有关。目前尚不清楚的是，儿童肥胖和代谢障碍的风险，或母亲糖代谢障碍的风险，以及母亲血糖连续体到糖尿病诊断水平的风险。高血糖和不良妊娠结局（HAPO）随访研究将从参加HAPO研究的妇女及其后代中招募，以解决这些问题。其假设是妊娠期高血糖，比显性糖尿病轻，与8-12年后儿童和孕产妇不良结局的风险增加独立相关。HAPO是一项观察性研究，使用共同的方案和数据收集工具、统一的人员培训和中心实验室，对一个大型、多民族、多种族的妊娠晚期妇女队列进行葡萄糖耐量检测。HAPO的假设是，妊娠期高血糖，没有明显的糖尿病严重，与孕产妇和新生儿不良结局的风险增加独立相关。其结果导致一个共识小组制定了新的国际妊娠糖尿病研究小组协会（IADPSG）诊断GDM的标准。在HAPO中，较高的母亲葡萄糖水平与出生体重、脐带血清C-肽和婴儿肥胖（第90百分位数）的频率增加独立相关。在糖尿病母亲的后代中，这些结果是儿童肥胖和代谢紊乱的危险因素，但这些关联的性质和与母亲血糖水平升高低于糖尿病诊断水平相关的危险程度，包括根据新的IADPSG标准患有GDM的母亲，尚不清楚。HAPO随访研究是解决这些重要问题的独特定位。其总体目标是获得肥胖、葡萄糖、胰岛素敏感性和分泌、脂质、