Cardiovascular and metabolic abnormalities in the offspring of diabetic pregnancy
Cardiovascular and metabolic abnormalities in the offspring of diabetic pregnancy
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DOI：
10.1007/s00125-002-0865-y
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发表时间：
2002-07-01
期刊：
影响因子：
8.2
通讯作者：
McCance, DR
中科院分区：
文献类型：
--
作者：
Manderson, JG;Mullan, B;McCance, DR
目的/假说。众所周知，母亲的燃料代谢对糖尿病母亲的孩子的后期发育有长期的影响。最近，成人生活中的心血管疾病已与胎儿营养不良联系起来。本研究的目的是确定糖尿病妊娠后代是否存在与燃料相关的心血管编程标志物。研究人员将61名患有I型（胰岛素依赖型）糖尿病母亲的5至11岁儿童与57名年龄、性别和社会阶层相似的非糖尿病母亲的随机对照儿童进行了比较。空腹取血检测血糖、胰岛素、血脂、IGF-1、纤溶酶原激活抑制剂I （PAI-1）及黏附分子ICAM-1、VCAM-1、e -选择素。两组的空腹血糖和胰岛素相似。糖尿病和非糖尿病孕妇的后代（平均+/- SD）总胆固醇（4.45 +/- 0.56 vs 4.18 +/- 0.66, p=0.03）、低密度脂蛋白胆固醇（2.73 +/- 0.49 vs 2.39 +/- 0.54, p=0.001）、胆固醇与高密度脂蛋白比值（3.41 +/- 0.76 vs 3.09 - 0.73, p=0.03）、IGF-1 （22.5 +/- 7.3 vs 19.3 +/- 8, p=0.04）、PAI-1 （20.1 +/- 6.2 vs 14.9 +/- 7.3, p=0.000）、VCAM-1 （1852 +/- 444 vs 1509 +/- 385, p=0.000）和e -选择素(几何平均；83.1 vs 63.9, p=0.001)。结论/解释。这些结果表明，即使在儿童时期，1型糖尿病和非糖尿病母亲的糖耐量儿童在心血管危险因素方面也存在重要差异。这些数据表明，糖尿病母亲的后代在以后的生活中患血管疾病的风险可能会增加。
Aims/hypothesis. Maternal fuel metabolism is known to exert long range effects on the later development of children of diabetic mothers. Recently cardiovascular disease in adult life has been linked retrospectively with foetal malnutrition. The aim of this study was to identify whether markers for fuel-related cardiovascular programming exist for the offspring of diabetic pregnancy.Methods. Sixty-one children aged 5 to 11 years, of mothers with Type I (insulin-dependent) diabetes mellitus were compared with 57 randomly selected control children of non-diabetic mothers similar in age, sex and social class. Fasting blood was taken for plasma glucose, insulin, lipids, IGF-1, plasminogen activating inhibitor I (PAI-1) and the adhesion molecules ICAM-1, VCAM-1 and E-Selectin.Results. Fasting glucose and insulin were similar in the two groups. Differences existed between the off-spring of diabetic and non-diabetic pregnancies (mean +/- SD) for total cholesterol (4.45 +/- 0.56 vs 4.18 +/- 0.66, p=0.03), LDL cholesterol (2.73 +/- 0.49 vs 2.39 +/- 0.54, p=0.001), Cholesterol -to- HDL ratio (3.41 +/- 0.76 vs 3.09 0.73, p=0.03), IGF-1 (22.5 +/- 7.3 vs 19.3 +/- 8, p=0.04), PAI-1 (20.1 +/- 6.2 vs 14.9 +/- 7.3, p=0.000), VCAM-1 (1852 +/- 444 vs 1509 +/- 385, p=0.000) and E-Selectin (geometric mean; 83.1 vs 63.9, p=0.001).Conclusion/interpretation. These results indicate that important differences in cardiovascular risk factors exist between glucose-tolerant children of Type I diabetic and non-diabetic mothers, even in childhood. These data suggest that offspring of diabetic mothers might be at an increased risk for the development of vascular disease in later life.