Glucose intolerance and cardiometabolic risk in children exposed to maternal gestational diabetes mellitus in utero.
OBJECTIVE
The goal was to examine the carbohydrate tolerance and cardiometabolic risk among children exposed to maternal gestational diabetes mellitus in utero.


METHODS
In this study, 164 Chinese children whose mothers had participated in a previous study on the screening and diagnosis of gestational diabetes mellitus (63 had gestational diabetes mellitus and 101 had normal glucose tolerance during the index pregnancies) underwent follow-up evaluations at a median age of 8 years (range: 7-10 years). Children's weight, height, hip and waist circumferences, and blood pressure were measured, and weight-adjusted oral glucose tolerance tests were performed.


RESULTS
Six children (3.7%) demonstrated impaired glucose regulation or diabetes mellitus at the follow-up evaluation. Children exposed to maternal gestational diabetes mellitus had significantly higher systolic (94+/-1.2 vs 88+/-0.9 mmHg) and diastolic (62+/-0.8 vs 57+/-0.6 mmHg) blood pressure values and lower high-density lipoprotein cholesterol (1.58+/-0.04 vs 1.71+/-0.03 mmol/L) levels, after adjustment for age and gender. A high (>or=90th percentile) umbilical cord insulin level at birth was associated with abnormal glucose tolerance in the offspring.


CONCLUSIONS
Maternal gestational diabetes mellitus increases the offspring's cardiometabolic risk, and in utero hyperinsulinemia is an independent predictor of abnormal glucose tolerance in childhood.
Tam
Wing Hung
WH
Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, First Floor, E Block, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR. tamwh@cuhk.edu.hk
Ma
Ronald Ching Wan
RC
Yang
Xilin
X
Ko
Gary Tin Choi
GT
Tong
Peter Chun Yip
PC
Cockram
Clive Stewart
CS
Sahota
Daljit Singh
DS
Rogers
Michael Scott
MS
Chan
Juliana Chung Ngor
JC
D017677:Age Distribution; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D017678:Sex Distribution
D001786:Blood Glucose