Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Harold Hamm Diabetes Center, 1200, Children's avenue Suite 4500, Oklahoma City, OK, 73104, USA.
Harold Hamm Diabetes Center, Oklahoma City, OK, USA.
Calcif Tissue Int. 2022 Sep;111(3):248-255. doi: 10.1007/s00223-022-00990-0. Epub 2022 May 27.
The perinatal period is a time of substantial bone mass accrual with many factors affecting long-term bone mineralization. Currently it is unclear what effect maternal gestational/type 2 diabetes has on infant bone mass accrual. This is a prospective study of offspring of Native American and Hispanic mothers with normoglycemia (n = 94) and gestational diabetes or type 2 diabetes (n = 64). Infant anthropometrics were measured at birth, 1, and 6 months of age. Cord blood leptin, high-molecular weight adiponectin (HMWA), pigment epithelium-derived factor (PEDF), vascular epithelium growth factor (VEGF), endoglin, and C-peptide were measured by ELISA. Infants had bone mineral density measurement at 1 month or/and 6 months of age using dual-energy x-ray absorptiometry scan. Mothers with diabetes were older (31 ± 6 years vs 25 ± 4 years) and had higher pre-pregnancy BMI (32.6 ± 5.8 vs 27.2 ± 6.4 kg/m) than control mothers. Mean HbA1C of mothers with diabetes was 5.9 ± 1.0% compared to 5.1 ± 0.3% in controls early in pregnancy. Infants born to mothers with diabetes (DM-O) were born at a slightly lower gestational age compared to infants born to control mothers (Con-O). There was no difference in total body less head bone mineral content (BMC) or bone mineral density (BMD) between DM-O and Con-O. For both groups together, bone area, BMD, and BMC tracked over the first 6 months of life (r: 0.56, 0.38, and 0.48, respectively). Percent fat was strongly and positively correlated with BMC at 1 month of age (r = 0.44; p < 0.001) and BMC at both 1 and 6 months of age correlated strongly with birth weight. There were no associations between infant bone mass and cord blood leptin, PEDF, or VEGF, while C-peptide had a significant correlation with BMC at 1 and 6 months only in DM-O (p = 0.01 and 0.03, respectively). Infants born to mothers with well-controlled gestational/type 2 diabetes have normal bone mass accrual. Bone mineral content during this time is highly correlated with indices of infant growth and the association of bone mineral indices with percent body fat suggests that bone-fat crosstalk is operative early in life.
围产期是骨量大量积累的时期,许多因素会影响长期的骨矿化。目前尚不清楚母体妊娠期/2 型糖尿病对婴儿骨量积累有何影响。这是一项针对具有正常血糖的美洲原住民和西班牙裔母亲(n=94)和患有妊娠糖尿病或 2 型糖尿病的母亲(n=64)的后代的前瞻性研究。在婴儿出生、1 个月和 6 个月时测量婴儿的人体测量指标。通过 ELISA 测量脐带血瘦素、高分子量脂联素(HMWA)、色素上皮衍生因子(PEDF)、血管内皮生长因子(VEGF)、内胚层和 C 肽。使用双能 X 射线吸收法扫描在 1 个月或/和 6 个月龄时测量婴儿的骨矿物质密度。患有糖尿病的母亲年龄较大(31±6 岁),孕前 BMI 较高(32.6±5.8 公斤/平方米 vs. 27.2±6.4 公斤/平方米)。患有糖尿病的母亲的平均 HbA1C 在妊娠早期为 5.9±1.0%,而对照组为 5.1±0.3%。与对照组相比,患有糖尿病的母亲(DM-O)的婴儿出生时的胎龄略低。DM-O 和 Con-O 之间的总身体(不含头部)骨矿物质含量(BMC)或骨矿物质密度(BMD)无差异。对于两组而言,骨面积、BMD 和 BMC 在生命的前 6 个月内均呈跟踪趋势(r:0.56、0.38 和 0.48)。1 个月龄时,脂肪百分比与 BMC 呈强烈正相关(r=0.44;p<0.001),1 个月和 6 个月龄时的 BMC 与出生体重强烈相关。婴儿骨量与脐带血瘦素、PEDF 或 VEGF 之间无关联,而 C 肽仅在 DM-O 中与 1 个月和 6 个月时的 BMC 呈显著相关(p=0.01 和 0.03)。患有经良好控制的妊娠期/2 型糖尿病的母亲所生的婴儿骨量积累正常。在此期间,骨矿物质含量与婴儿生长指数高度相关,骨矿物质指数与体脂百分比的关联表明骨-脂相互作用在生命早期就已发生。