Kalkhoff R K, Kandaraki E, Morrow P G, Mitchell T H, Kelber S, Borkowf H I
Department of Medicine, Medical College, Milwaukee 53226.
Metabolism. 1988 Mar;37(3):234-9. doi: 10.1016/0026-0495(88)90101-1.
Profiles of hemoglobin A1c (HbA1c) and concentrations of plasma glucose and 18 plasma amino acids were obtained in ten nonobese, insulin-dependent type I diabetic women, in 9 age- and weight-matched normal women and in ten obese nondiabetic women throughout pregnancy and postpartum. In late gestation, the period of maximum fetal growth, average HbA1c, plasma glucose, and total amino acid concentrations in diabetic mothers were significantly elevated above lean control values. No differences existed between the obese and lean control groups. Lean diabetic mothers also had significantly heavier babies (mean +/- SEM) relative to the 50th percentile for gestational age and sex (119 +/- 9%) than did the lean control group (94 +/- 3%, P less than .05). Relative birth weights among control lean and obese mothers did not differ significantly (94 +/- 3% v 104 +/- 5%). Late pregnancy profiles of HbA1c and average plasma glucose did not correlate with relative weight of neonates whereas average total plasma amino acids and six individual amino acids did correlate with this parameter. These data suggest that maternal plasma amino acid concentrations may influence fetal weight generally and may have an important role in the development of fetal macrosomia in diabetic pregnancies.
在整个孕期及产后，对10名非肥胖、胰岛素依赖型I型糖尿病女性、9名年龄和体重匹配的正常女性以及10名肥胖非糖尿病女性进行了糖化血红蛋白（HbA1c）水平、血浆葡萄糖浓度和18种血浆氨基酸浓度的检测。在妊娠晚期，即胎儿生长最快的时期，糖尿病母亲的平均HbA1c、血浆葡萄糖和总氨基酸浓度显著高于非糖尿病对照组。肥胖对照组与非肥胖对照组之间无差异。与孕周和性别处于第50百分位数相比，非肥胖糖尿病母亲所生婴儿也显著更重（平均±标准误，为119±9%），而非肥胖对照组为94±3%（P<0.05）。非肥胖对照组母亲与肥胖对照组母亲的相对出生体重无显著差异（94±3%对104±5%）。妊娠晚期HbA1c水平和平均血浆葡萄糖与新生儿相对体重无相关性，而平均血浆总氨基酸和六种单个氨基酸与该参数相关。这些数据表明，母亲血浆氨基酸浓度可能总体上影响胎儿体重，并且在糖尿病妊娠胎儿巨大儿的发生中可能起重要作用。
