对子宫内暴露于妊娠期糖尿病的儿童的选定碳水化合物参数进行评估。

Assessment of selected carbohydrate parameters in children exposed to gestational diabetes in utero.

作者信息

Wilk Malgorzata, Horodnicka-Józwa Anita, Moleda Piotr, Petriczko Elżbieta, Safranow Krzysztof, Chojnacka Hanna, Gawrych Elzbieta, Walczak Alicja, Walczak Mieczysław

机构信息

Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland.

Department of Diabetology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.

出版信息

Neuro Endocrinol Lett. 2015;36(5):504-10.

PMID:26707052

Abstract

OBJECTIVES

The study was undertaken to assess the selected carbohydrate parameters in children exposed to gestational diabetes in utero.

METHODS

50 children exposed to gestational diabetes were compared with 46 control subjects. Anthropometric parameters of a newborn were obtained from the medical records. In all participants height, body mass, waist and hip circumferences were measured; BMI, WHR and WHtR were calculated. Values of fasting glucose, insulin, C-peptide and HbA1c were measured and HOMA2-IR, HOMA2-S, HOMA2-B were calculated. In obese children (BMI ≥95th percentile) OGTT was performed.

RESULTS

The prevalence of overweight/obesity in the study group was 38%, in the control group 41% (p=0.19). Higher fasting glucose level (p=0.02) and HbA1c (p=0.00004) were found in the study group comparing to the control. In children exposed to GDM in utero a positive correlation of fasting insulin and WHR (Rs=0.31, p=0.028) as well as significantly lower HOMA2-B (p=0.03) were observed. In the study group higher HOMA2-IR (p=0.0002) and HOMA2-B (p=0.0000039) and also lower HOMA2-S (p=0.0002) were observed among participants with overweight/obesity comparing to children with normal body weight. In the study group a correlation of HOMA2-IR and SD of the birth weight was found (Rs=0.28, p=0.049).

CONCLUSIONS

Children exposed to gestational diabetes in utero, in spite of similar prevalence of overweight/obesity comparing to their non-exposed peers, could have higher risk of glucose intolerance and diabetes mellitus in future. Towards observed decreased insulin sensitivity and compensatory increase in insulin secretion, prevention of overweight and obesity in this group seems to be essential.

摘要

目的

本研究旨在评估子宫内暴露于妊娠期糖尿病的儿童的选定碳水化合物参数。

方法

将50名子宫内暴露于妊娠期糖尿病的儿童与46名对照受试者进行比较。从医疗记录中获取新生儿的人体测量参数。测量所有参与者的身高、体重、腰围和臀围；计算BMI、WHR和WHtR。测量空腹血糖、胰岛素、C肽和HbA1c值，并计算HOMA2-IR、HOMA2-S、HOMA2-B。对肥胖儿童（BMI≥第95百分位数）进行口服葡萄糖耐量试验（OGTT）。

结果

研究组超重/肥胖的患病率为38%，对照组为41%（p=0.19）。与对照组相比，研究组的空腹血糖水平（p=0.02）和HbA1c（p=0.00004）更高。在子宫内暴露于妊娠期糖尿病的儿童中，观察到空腹胰岛素与WHR呈正相关（Rs=0.31，p=0.028），且HOMA2-B显著降低（p=0.03）。在研究组中，与体重正常的儿童相比，超重/肥胖参与者的HOMA2-IR（p=0.0002）和HOMA2-B（p=0.0000039）更高，而HOMA2-S更低（p=0.0002）。在研究组中，发现HOMA2-IR与出生体重标准差之间存在相关性（Rs=0.28，p=0.049）。