title: Cardiovascular risk factors in children exposed to maternal diabetes in utero.
abstract: OBJECTIVE
  Recent studies have provided evidence that intrauterine exposure to maternal diabetes has lifelong effects on adult offspring, including increased risks of obesity, type 2 diabetes and cardiovascular disease. The aim of this study was to assess the relationship between exposure to maternal diabetes in utero and cardiovascular risk factors in healthy children and to investigate whether these associations are independent of maternal prepregnancy BMI and offspring attained BMI.
  
  
  METHODS
  Data were from a retrospective cohort of children aged 6-13 years born during 1994-2002. Multiple linear regression was used to examine the associations between exposure and cardiovascular risk factors with adjustment for demographic factors and pubertal stage and additionally for maternal prepregnancy BMI and offspring attained BMI.
  
  
  RESULTS
  Ninety-nine offspring of diabetic pregnancies had significantly increased E-selectin, vascular adhesion molecule 1 (VCAM1), leptin, waist circumference, BMI and systolic blood pressure and decreased adiponectin levels compared with 422 offspring of non-diabetic pregnancies after adjustment for age, sex and race/ethnicity (p < 0.05 for each risk factor). Additional adjustment for maternal prepregnancy BMI substantially attenuated group differences in the risk factors except for E-selectin, VCAM1 and waist circumference, which remained significantly higher in exposed children.
  
  
  CONCLUSIONS
  Compared with unexposed children, healthy offspring exposed to maternal diabetes in utero have a worse cardiovascular risk profile. In particular, offspring have substantially increased levels of circulating cellular adhesion molecules, which are biomarkers of adverse endothelium perturbation and may be related to the earliest preclinical stages of atherosclerosis and diabetes.
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, 13001 East 17th Avenue, Campus Box B-119, Aurora, CO 80045, USA. Nancy.West@ucdenver.edu
authors.forename: N A
authors.initials: NA
authors.lastname: West
authors.forename: T L
authors.initials: TL
authors.lastname: Crume
authors.forename: M A
authors.initials: MA
authors.lastname: Maligie
authors.forename: D
authors.initials: D
authors.lastname: Dabelea
mesh_terms: D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D006631:Amine Oxidase (Copper-Containing) / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D015815:Cell Adhesion Molecules / Q000097:blood; D002648:Child; D016640:Diabetes, Gestational / Q000503:physiopathology*; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood; D016014:Linear Models; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D052242:Adiponectin; D015815:Cell Adhesion Molecules; D019040:E-Selectin; D020738:Leptin; C076668:AOC3 protein, human; D006631:Amine Oxidase (Copper-Containing)