Hyperglycemia and Pregnancy Outcome(HAPO) Follow Up Study

高血糖与妊娠结局（HAPO）随访研究

• 批准号: 8636468
• 负责人: BOYD E METZGER
• 金额: $ 445.32万
• 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/8636468
• 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)：患有既往糖尿病(DM)或妊娠期糖尿病(GDM)的母亲的子女患儿童肥胖症的风险增加。妊娠期糖尿病还与母亲患2型糖尿病的风险增加有关。目前尚不清楚的是，儿童肥胖和代谢紊乱的风险或母亲的葡萄糖代谢紊乱沿着母亲血糖的连续体水平达到诊断糖尿病的水平。高血糖和不良妊娠结局(HAPO)后续研究将从参与HAPO研究的妇女及其子女的队列中招募，以解决这些问题。它的假设是妊娠期高血糖，没有明显的糖尿病严重，独立地与8-12年后不良儿童和母亲结局的风险增加有关。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，检查了一大群不同种族、多个国家的妊娠晚期妇女的葡萄糖耐量。Hapo的假设是妊娠期高血糖，没有明显的糖尿病严重，与母亲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期糖尿病协会(IADPSG)诊断妊娠期糖尿病的标准。在HAPO患者中，较高的母体血糖水平与出生体重、脐带血C-肽和婴儿肥胖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风险因素，但这些关联的性质和与母亲血糖水平低于糖尿病诊断水平相关的风险大小尚不清楚，包括根据新的IADPSG标准患有妊娠期糖尿病的母亲。HAPO后续研究对解决这些重要问题具有独特的地位。它的总体目标是获得肥胖、血糖、胰岛素敏感性和分泌、血脂、 在15个HAPO现场中心中的10个，对7,000对多民族/种族的HAPO母子(8-12岁)进行了炎症和血压(BP)的研究。主要目标和假设是：主要目标1：确定怀孕期间母体血糖水平与子代肥胖程度的相关性。假设1：母亲的血糖水平，包括那些新归类为妊娠期糖尿病的水平，与后代的肥胖指标(肥胖、超重、脂肪百分比)呈正相关且独立相关。主要目标2：确定孕期母体血糖水平与8-12年后母体代谢紊乱的关系。假设2：孕妇的血糖水平，包括那些新归类为妊娠期糖尿病的孕妇，与后来的孕妇患糖代谢紊乱(糖尿病、空腹血糖受损、糖耐量受损)的风险呈正相关且独立相关。次级目标将检查怀孕期间母亲血糖水平与血糖和胰岛素敏感性以及后代分泌、血脂、血压和炎症的关系，以及母亲心血管风险的衡量标准。