Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India.
Diabetes Care. 2010 Feb;33(2):402-4. doi: 10.2337/dc09-1393. Epub 2009 Nov 16.
To test the hypothesis that maternal gestational diabetes increases cardiovascular risk markers in Indian children.
Anthropometry, blood pressure, and glucose/insulin concentrations were measured in 514 children at 5 and 9.5 years of age (35 offspring of diabetic mothers [ODMs], 39 offspring of diabetic fathers [ODFs]). Children of nondiabetic parents were control subjects.
At age 9.5 years, female ODMs had larger skinfolds (P < 0.001), higher glucose (30 min) and insulin concentrations, and higher homeostasis model assessment (HOMA) of insulin resistance and systolic blood pressure (P < 0.05) than control subjects. Male ODMs had higher HOMA (P < 0.01). Associations were stronger than at age 5 years. Female ODFs had larger skinfolds and male ODFs had higher HOMA (P < 0.05) than control subjects; associations were weaker than for ODMs. Associations between outcomes in control subjects and parental BMI, glucose, and insulin concentrations were similar for mothers and fathers.
The intrauterine environment experienced by ODMs increases diabetes and cardiovascular risk over genetic factors; the effects strengthen during childhood.
检验母体妊娠期糖尿病会增加印度儿童心血管风险标志物的假设。
在 5 岁和 9.5 岁时,对 514 名儿童进行了人体测量、血压和血糖/胰岛素浓度测量(35 名糖尿病母亲的后代 [ODM],39 名糖尿病父亲的后代 [ODF])。非糖尿病父母的孩子为对照组。
在 9.5 岁时,女性 ODM 的皮褶厚度更大(P < 0.001),血糖(30 分钟)和胰岛素浓度更高,以及胰岛素抵抗的稳态模型评估(HOMA)和收缩压更高(P < 0.05),高于对照组。男性 ODM 的 HOMA 更高(P < 0.01)。这些关联比 5 岁时更强。女性 ODF 的皮褶厚度更大,男性 ODF 的 HOMA 更高(P < 0.05),高于对照组;与 ODM 相比,这些关联较弱。对照组中与父母 BMI、血糖和胰岛素浓度相关的结果与母亲和父亲的结果相似。
ODM 所经历的宫内环境会增加糖尿病和心血管风险,超过遗传因素;这些影响在儿童时期会加强。