Intrauterine exposure to gestational diabetes, child adiposity, and blood pressure.
Intrauterine exposure to gestational diabetes, child adiposity, and blood pressure.
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DOI：
10.1038/ajh.2008.326
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发表时间：
2009-02
影响因子：
3.2
通讯作者：
Oken, Emily
中科院分区：
文献类型：
--
作者：
Wright, Charmaine S.;Rifas-Shiman, Sheryl L.;Rich-Edwards, Janet W.;Taveras, Elsie M.;Gillman, Matthew W.;Oken, Emily
宫内暴露于妊娠期糖尿病（GDM）可能促进后代肥胖和青春期收缩压（SBP）升高。很少有研究检查年幼儿童暴露于GDM的肥胖或收缩压。本研究的目的是研究孕期母亲糖耐量与后代3岁时肥胖和收缩压的关系。我们在Viva项目中研究了1238对母婴，这是一项前瞻性的产前队列研究。暴露于口服葡萄糖负荷后的母亲血糖，并通过3小时葡萄糖耐量试验证实GDM。主要儿童结局为3岁体重指数（BMI） z-score、肩胛下（SS）和肱三头肌（TR）皮褶厚度之和（SS+TR）和比值（SS/TR）、收缩压。我们进行了调整的多变量分析。51位（4%）母亲患有GDM。9.3%的3岁儿童肥胖，平均（标准差）。收缩压为92 (11)mm Hg。暴露于GDM的儿童有较高的收缩压（3.2 mm Hg， 95%可信区间（CI）： 0.4, 5.9, P = 0.02）和更大的肥胖，通过皮肤褶皱（SS+TR 1.31 mm, 95% CI: 0.08, 2.55, P = 0.04）评估，但没有通过BMI z评分（- 0.08单位，95% CI: - 0.37, 0.22, P = 0.61）。在对皮褶厚度之和（SS+TR）进行额外调整后，GDM和收缩压之间的关系减弱，不再显著（2.6 mm Hg, 95% CI: - 0.2, 5.4, P = 0.07）。暴露于GDM的儿童有较高的肥胖，这可能介导了这些儿童较高的收缩压。这些发现延伸到年幼的儿童，以前在青少年和成人中发现的GDM的不良影响。
Intrauterine exposure to gestational diabetes mellitus (GDM) may promote offspring obesity and higher systolic blood pressure (SBP) by adolescence. Few studies have examined adiposity or SBP in younger children exposed to GDM. This study’s objective was to examine associations of maternal glucose tolerance during pregnancy with offspring adiposity and SBP at age 3 years. We studied 1,238 mother-child pairs in Project Viva, a prospective prebirth cohort study. Exposures were maternal blood glucose following oral glucose load, and GDM confirmed by 3-h glucose tolerance test. Main child outcomes were age 3-year body mass index (BMI) z-score, the sum (SS+TR) and ratio (SS/TR) of subscapular (SS) and tricep (TR) skinfold thicknesses, and SBP. We performed adjusted multivariable analyses. Fifty-one (4%) mothers had GDM. 9.3% of 3 year-old children were obese and mean (s.d.) SBP was 92 (11) mm Hg. Children exposed to GDM had higher SBP (3.2 mm Hg, 95% confidence interval (CI): 0.4, 5.9, P = 0.02) and greater adiposity when assessed by the sum of skinfolds (SS+TR 1.31 mm, 95% CI: 0.08, 2.55, P = 0.04) but not by BMI z-score (−0.08 units, 95% CI: −0.37, 0.22, P = 0.61). After additional adjustment for the sum of skinfold thicknesses (SS+TR), the relationship between GDM and SBP was attenuated and no longer significant (2.6 mm Hg, 95% CI: −0.2, 5.4, P = 0.07). Children exposed to GDM have higher adiposity, which may mediate the higher SBP in these children. These findings extend to younger children the adverse effects of GDM previously found among adolescents and adults.
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影响因子：
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