MRC (Medical Research Council) Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Diabetes Care. 2012 Jan;35(1):63-71. doi: 10.2337/dc11-1633. Epub 2011 Nov 28.
To assess associations of gestational diabetes, existing diabetes, and glycosuria with adiposity and cardiometabolic risk factors in offspring at adolescence.
Multivariable regression analyses were conducted in a prospective pregnancy cohort (n = 2,563-4,198 for different outcomes). Obstetric data were abstracted from clinical records. Offspring outcomes were assessed at mean age 15.5 years. Compared with those lost to follow-up, participants included in the analysis were of higher socioeconomic position. Outcomes included BMI, waist circumference, fat mass determined by dual-energy X-ray absorptiometry scan, systolic and diastolic blood pressure (sBP and dBP, respectively), fasting glucose, insulin, lipids, and C-reactive protein (CRP).
Maternal existing diabetes, gestational diabetes, and glycosuria were associated with higher offspring BMI and fat mass (z scores); however, this effect was attenuated in the confounder-adjusted model, and the CIs included the null value. Existing diabetes and gestational diabetes were associated with higher offspring fasting glucose levels (0.24 mmol/L [95% CI 0.03-0.45] and 0.20 mmol/L [0.02-0.39], respectively). Glycosuria was associated with higher fasting insulin (adjusted ratio of geometric means 1.12 [1.01-1.25]), but there were no clear associations of existing or gestational diabetes with offspring fasting insulin. There was little evidence of an association of maternal diabetes or glycosuria with offspring dBP, sBP, lipids, or CRP.
Maternal pregnancy glycosuria, gestational diabetes, and existing diabetes show some associations with higher offspring fasting glucose and insulin assessed in adolescence but are not clearly associated with a wider range of cardiometabolic risk factors.
评估妊娠期糖尿病、现有糖尿病和糖尿与青少年后代肥胖和心血管代谢危险因素的相关性。
在一项前瞻性妊娠队列中进行了多变量回归分析(不同结局的 n=2563-4198)。从临床记录中提取产科数据。在平均年龄为 15.5 岁时评估后代结局。与随访丢失者相比,纳入分析的参与者具有更高的社会经济地位。结局包括 BMI、腰围、双能 X 射线吸收仪扫描确定的体脂肪量、收缩压和舒张压(分别为 sBP 和 dBP)、空腹血糖、胰岛素、血脂和 C 反应蛋白(CRP)。
母亲现有糖尿病、妊娠期糖尿病和糖尿与后代 BMI 和体脂肪量(z 评分)较高有关;然而,在调整混杂因素后,这种影响减弱,CI 包含了零值。现有糖尿病和妊娠期糖尿病与后代空腹血糖水平升高有关(分别为 0.24mmol/L[95%CI 0.03-0.45]和 0.20mmol/L[0.02-0.39])。糖尿与空腹胰岛素升高有关(调整后的几何均数比 1.12[1.01-1.25]),但现有或妊娠期糖尿病与后代空腹胰岛素之间似乎没有明确的关联。母亲糖尿病或糖尿与后代舒张压、收缩压、血脂或 CRP 之间几乎没有关联的证据。
母亲妊娠期间的糖尿、妊娠期糖尿病和现有糖尿病与青少年后代的空腹血糖和胰岛素升高有一定的相关性,但与更广泛的心血管代谢危险因素没有明显的相关性。