Dörner G, Plagemann A, Reinagel H
Exp Clin Endocrinol. 1987 Mar;89(1):84-90. doi: 10.1055/s-0029-1210631.
A significantly decreased familial diabetes aggregation on the maternal side of insulin-dependent diabetic children born between 1974 and 1984 as compared to those born between 1960 and 1973 was observed. This phenomenon was explained by an increased prevention of hyperglycaemia during pregnancy since 1974, particularly of gestational diabetes in women with familial diabetes aggregation. A highly significant predominance of Type II diabetes was found in great-grandmothers of infantile-onset diabetics on the maternal side as compared to the paternal side. This finding may suggest that gestational diabetes, which can represent a risk factor for diabetes transmission on the maternal side, is often followed by "extragestational" type II diabetes in higher age. This conclusion is supported by the data of familial diabetes aggregation obtained in insulin-dependent infantile- or juvenile-onset diabetics, when familial diabetes aggregation was ascertained as late as at least 20 years after birth of the diabetics. In this case, a significant predominance of familial diabetes aggregation in first- and second-degree relatives, particularly in grandmothers, was found on the maternal side as compared to the paternal side. All these findings are consistent with a teratogenetic effect of gestational diabetes on diabetes susceptibility in the offspring, which can be prevented by avoiding hyperglycaemia in pregnant women and hyperinsulinism in foetuses.
与1960年至1973年出生的胰岛素依赖型糖尿病儿童相比，观察到1974年至1984年出生的此类儿童母系家族性糖尿病聚集性显著降低。这一现象可解释为自1974年以来孕期高血糖的预防有所增加，尤其是有家族性糖尿病聚集性的女性中的妊娠期糖尿病。在母系家族中，婴儿期发病的糖尿病患者的曾祖母中II型糖尿病的占比显著高于父系家族。这一发现可能表明，妊娠期糖尿病作为母系糖尿病遗传的一个风险因素，在高龄时往往会发展为“非妊娠期”II型糖尿病。这一结论得到了胰岛素依赖型婴儿期或青少年期发病的糖尿病患者家族性糖尿病聚集性数据的支持，这些数据是在糖尿病患者出生至少20年后才确定家族性糖尿病聚集性的。在这种情况下，与父系家族相比，母系家族中一级和二级亲属，尤其是祖母，家族性糖尿病聚集性显著占优。所有这些发现都与妊娠期糖尿病对后代糖尿病易感性的致畸作用相一致，这种作用可通过避免孕妇高血糖和胎儿高胰岛素血症来预防。
