Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism
Publication in refereed journal


摘要OBJECTIVE Whether hyperglycemiainuterolessthanovertdiabetesisassociatedwithaltered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort.
RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers hada75-gOGTTat∼28weeksofgestationwithblindedglucosevalues.Theprimary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index.
RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95% CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index.
CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.
著者Lowe WL, Scholtens DM, Kuang A, Linder B, Lawrence JM, Lebenthal Y, McCance D, Hamilton J, Nodzenski M, Talbot O, Brickman WJ, Clayton P, Ma RC, Tam WH, Dyer AR, Catalano PM, Lowe LP, Metzger BE, on behalf of the HAPO Follow-up Study Cooperative Research Group
期刊名稱Diabetes Care
頁次372 - 380

上次更新時間 2020-07-08 於 02:10