Cardiovascular and metabolic abnormalities in the offspring of diabetic pregnancy

• Published in: Diabetologia Vol. 45; no. 7; pp. 991 - 996
• Main Authors: MANDERSON, J. G, MULLAN, B, PATTERSON, C. C, HADDEN, D. R, TRAUB, A. I, MCCANCE, D. R
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.07.2002; Springer Nature B.V
• Subjects: Atherosclerosis; Biological and medical sciences; Birth Weight; Blood Glucose - metabolism; Blood Pressure; Cardiovascular disease; Child; Child, Preschool; Cholesterol; Cholesterol - blood; Diabetes; Diabetes Mellitus, Type 1 - physiopathology; Endocrinology; Epidemiology; Female; Gestational Age; Glucose; Gynecology. Andrology. Obstetrics; Heart Defects, Congenital - epidemiology; Hospitals; Humans; Hypotheses; Insulin resistance; Insulin-Like Growth Factor I - metabolism; Lipoproteins - blood; Male; Management. Prenatal diagnosis; Medical sciences; Metabolic Diseases - epidemiology; Metabolism; Mothers; Pregnancy; Pregnancy in Diabetics - physiopathology; Pregnancy. Fetus. Placenta; Prenatal Exposure Delayed Effects; Reference Values; Regression Analysis; Risk factors; Social classes; Womens health; Endocrinopathy; Human; Pregnancy disorders; offspring of diabetic mothers; Diabetes mellitus; Cardiovascular disease; Diabetic pregnancy; Maternal diseases; Pregnancy; foetal programming; Progeny; Fetus; Child
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-002-0865-y

Maternal fuel metabolism is known to exert long range effects on the later development of children of diabetic mothers. Recently cardiovascular disease in adult life has been linked retrospectively with foetal malnutrition. The aim of this study was to identify whether markers for fuel-related cardiovascular programming exist for the offspring of diabetic pregnancy. Sixty-one children aged 5 to 11 years, of mothers with Type I (insulin-dependent) diabetes mellitus were compared with 57 randomly selected control children of non-diabetic mothers similar in age, sex and social class. Fasting blood was taken for plasma glucose, insulin, lipids, IGF-1, plasminogen activating inhibitor 1 (PAI-1) and the adhesion molecules ICAM-1, VCAM-1 and E-Selectin. Fasting glucose and insulin were similar in the two groups. Differences existed between the offspring of diabetic and non-diabetic pregnancies (mean +/- SD) for total cholesterol (4.45+/-0.56 vs 4.18+/-0.66, p=0.03 ), LDL cholesterol (2.73+/-0.49 vs 2.39+/-0.54, p=0.001), Cholesterol-to-HDL ratio (3.41+/-0.76 vs 3.09+/-0.73, p=0.03), IGF-1 (22.5+/-7.3 vs 19.3+/-8, p=0.04), PAI-1 (20.1+/-6.2 vs 14.9+/-7.3, p=0.000), VCAM-1 (1852+/-444 vs 1509+/-385, p=0.000) and E-Selectin (geometric mean; 83.1 vs 63.9, p=0.001). These results indicate that important differences in cardiovascular risk factors exist between glucose-tolerant children of Type I diabetic and non-diabetic mothers, even in childhood. These data suggest that offspring of diabetic mothers might be at an increased risk for the development of vascular disease in later life.