Cardiovascular and metabolic abnormalities in the offspring of diabetic pregnancy.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Royal Jubilee Maternity Hospital, Royal Victoria Hospital, Belfast, UK.
J G
JG
Manderson
B
B
Mullan
C C
CC
Patterson
D R
DR
Hadden
A I
AI
Traub
D R
DR
McCance
D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D011297:Prenatal Exposure Delayed Effects; D012016:Reference Values; D012044:Regression Analysis
D001786:Blood Glucose; D008074:Lipoproteins; D007334:Insulin-Like Growth Factor I; D002784:Cholesterol