title: Fetal exposure to maternal type 1 diabetes is associated with renal dysfunction at adult age.
abstract: OBJECTIVE
  In animal studies, hyperglycemia during fetal development reduces nephron numbers. We tested whether this observation translates into renal dysfunction in humans by studying renal functional reserve in adult offspring exposed in utero to maternal type 1 diabetes.
  
  
  METHODS
  We compared 19 nondiabetic offspring of type 1 diabetic mothers with 18 offspring of type 1 diabetic fathers (control subjects). Glomerular filtration rate ((51)Cr-EDTA clearance), effective renal plasma flow ((123)I-hippurate clearance), mean arterial pressure, and renal vascular resistances were measured at baseline and during amino acid infusion, which mobilizes renal functional reserve.
  
  
  RESULTS
  Offspring of type 1 diabetic mothers were similar to control subjects for age (median 27, range 18-41, years), sex, BMI (23.1 ± 3.7 kg/m(2)), and birth weight (3,288 ± 550 vs. 3,440 ± 489 g). During amino acid infusion, glomerular filtration rate and effective renal plasma flow increased less in offspring of type 1 diabetic mothers than in control subjects: from 103 ± 14 to 111 ± 17 ml/min (8 ± 13%) vs. from 108 ± 17 to 128 ± 23 ml/min (19 ± 7%, P = 0.009) and from 509 ± 58 to 536 ± 80 ml/min (5 ± 9%) vs. from 536 ± 114 to 620 ± 140 ml/min (16 ± 11%, P = 0.0035). Mean arterial pressure and renal vascular resistances declined less than in control subjects: 2 ± 5 vs. -2 ± 3% (P = 0.019) and 3 ± 9 vs. -14 ± 8% (P = 0.001).
  
  
  CONCLUSIONS
  Reduced functional reserve may reflect a reduced number of nephrons undergoing individual hyperfiltration. If so, offspring of type 1 diabetic mothers may be predisposed to glomerular and vascular diseases.
authors.affiliation: Diabetes Department, Groupe Hospitalier Bichat–Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Charbel
authors.initials: C
authors.lastname: Abi Khalil
authors.forename: Florence
authors.initials: F
authors.lastname: Travert
authors.forename: Sabrina
authors.initials: S
authors.lastname: Fetita
authors.forename: François
authors.initials: F
authors.lastname: Rouzet
authors.forename: Raphael
authors.initials: R
authors.lastname: Porcher
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Riveline
authors.forename: Samy
authors.initials: S
authors.lastname: Hadjadj
authors.forename: Etienne
authors.initials: E
authors.lastname: Larger
authors.forename: Ronan
authors.initials: R
authors.lastname: Roussel
authors.forename: Patrick
authors.initials: P
authors.lastname: Vexiau
authors.forename: Dominique
authors.initials: D
authors.lastname: Le Guludec
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Gautier
authors.forename: Michel
authors.initials: M
authors.lastname: Marre
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology; D005220:Fathers; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009035:Mothers; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D014655:Vascular Resistance / Q000502:physiology; D055815:Young Adult