Lindsay R S, Hanson R L, Bennett P H, Knowler W C
National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Phoenix, Arizona 85014, USA.
Diabetes Care. 2000 Sep;23(9):1249-54. doi: 10.2337/diacare.23.9.1249.
The offspring of mothers who had diabetes during pregnancy experience increased risk later of diabetes and obesity later. We hypothesized that, in light of the historical improvements in the management of diabetes during pregnancy, these late consequences of the early environment might be diminishing with time.
Birth weight and information on BMI and glucose tolerance have been collected as part of the epidemiological survey of the Gila River Indian Community in Arizona. We examined birth weight, BMI, and diabetes in offspring of mothers with type 2 diabetes during pregnancy born in four 10-year time intervals since 1955 compared with offspring whose mothers either had not developed diabetes or were prediabetic (i.e., developed diabetes after the index pregnancy).
Offspring of diabetic mothers (ODM) were heavier at birth, had a higher BMI at all ages throughout childhood, and had an increased incidence rate of diabetes in childhood and early adulthood (7- to 20-fold, offspring of nondiabetic mothers [ONDM]; 3- to 5-fold, offspring of prediabetic mothers [OPDM]). Relative differences in birth weight and BMI between ODM and ONDM were greatest for those born before 1965. In those born after 1965, despite secular trends to higher BMI and diabetes incidence in the ONDM, differences in BMI and birth weight of ODM versus ONDM and OPDM appeared to have been maintained.
With the possible exception of individuals born before 1965, the increased risk of diabetes and obesity experienced by ODM does not seem to be diminishing with time.
孕期患糖尿病母亲的后代日后患糖尿病和肥胖症的风险会增加。我们推测，鉴于孕期糖尿病管理方面的历史性改善，早期环境带来的这些后期影响可能会随着时间推移而减弱。
作为亚利桑那州吉拉河印第安社区流行病学调查的一部分，收集了出生体重以及体重指数（BMI）和糖耐量信息。我们研究了自1955年以来四个10年时间间隔内出生的、孕期患有2型糖尿病母亲的后代的出生体重、BMI和糖尿病情况，并与母亲未患糖尿病或处于糖尿病前期（即在本次索引妊娠后患糖尿病）的后代进行了比较。
糖尿病母亲的后代（ODM）出生时体重更重，在整个童年期各年龄段的BMI都更高，且在儿童期和成年早期患糖尿病的发病率增加（是非糖尿病母亲的后代[ONDM]的7至20倍；是糖尿病前期母亲的后代[OPDM]的3至5倍）。ODM与ONDM之间出生体重和BMI的相对差异在1965年之前出生的人群中最大。在1965年之后出生的人群中，尽管ONDM存在BMI和糖尿病发病率上升的长期趋势，但ODM与ONDM和OPDM之间BMI和出生体重的差异似乎一直存在。
除了1965年之前出生的个体外，ODM患糖尿病和肥胖症的风险增加似乎并未随着时间推移而减弱。
