Tam Wing Hung, Ma Ronald Ching Wan, Yang Xilin, Ko Gary Tin Choi, Tong Peter Chun Yip, Cockram Clive Stewart, Sahota Daljit Singh, Rogers Michael Scott, Chan Juliana Chung Ngor
Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, First Floor, E Block, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR.
Pediatrics. 2008 Dec;122(6):1229-34. doi: 10.1542/peds.2008-0158.
The goal was to examine the carbohydrate tolerance and cardiometabolic risk among children exposed to maternal gestational diabetes mellitus in utero.
In this study, 164 Chinese children whose mothers had participated in a previous study on the screening and diagnosis of gestational diabetes mellitus (63 had gestational diabetes mellitus and 101 had normal glucose tolerance during the index pregnancies) underwent follow-up evaluations at a median age of 8 years (range: 7-10 years). Children's weight, height, hip and waist circumferences, and blood pressure were measured, and weight-adjusted oral glucose tolerance tests were performed.
Six children (3.7%) demonstrated impaired glucose regulation or diabetes mellitus at the follow-up evaluation. Children exposed to maternal gestational diabetes mellitus had significantly higher systolic (94+/-1.2 vs 88+/-0.9 mmHg) and diastolic (62+/-0.8 vs 57+/-0.6 mmHg) blood pressure values and lower high-density lipoprotein cholesterol (1.58+/-0.04 vs 1.71+/-0.03 mmol/L) levels, after adjustment for age and gender. A high (>or=90th percentile) umbilical cord insulin level at birth was associated with abnormal glucose tolerance in the offspring.
Maternal gestational diabetes mellitus increases the offspring's cardiometabolic risk, and in utero hyperinsulinemia is an independent predictor of abnormal glucose tolerance in childhood.
本研究旨在探讨子宫内暴露于母亲妊娠期糖尿病的儿童的糖耐量及心脏代谢风险。
在本研究中，164名中国儿童（其母亲曾参与一项关于妊娠期糖尿病筛查与诊断的研究，其中63名母亲患有妊娠期糖尿病，101名母亲在本次妊娠期间糖耐量正常）在中位年龄8岁（范围：7 - 10岁）时接受了随访评估。测量了儿童的体重、身高、臀围和腰围以及血压，并进行了体重校正的口服葡萄糖耐量试验。
在随访评估中，6名儿童（3.7%）出现了血糖调节受损或糖尿病。在调整年龄和性别后，子宫内暴露于母亲妊娠期糖尿病的儿童收缩压（94±1.2 vs 88±0.9 mmHg）和舒张压（62±0.8 vs 57±0.6 mmHg）显著更高，高密度脂蛋白胆固醇水平更低（1.58±0.04 vs 1.71±0.03 mmol/L）。出生时脐血胰岛素水平高（≥第90百分位数）与后代糖耐量异常有关。
母亲妊娠期糖尿病会增加后代的心脏代谢风险，子宫内高胰岛素血症是儿童糖耐量异常的独立预测因素。
