title: Obesity and type 2 diabetes mellitus in a birth cohort of First Nation children born to mothers with pediatric-onset type 2 diabetes.
abstract: BACKGROUND
  Children who are born to mothers with pediatric-onset type 2 diabetes mellitus are exposed to a hyperglycemic intra-uterine environment throughout pregnancy. The growth patterns and risk of type 2 diabetes in these offspring may be influenced by unique gene-environment interactions during intra-uterine and postnatal life.
  
  
  METHODS
  We established a cohort of offspring of First Nation mothers with onset of type 2 diabetes before age 18 years in Manitoba, Canada.
  
  
  METHODS
  We measured height or length and weight at study entry and annually thereafter with fasting blood glucose in offspring aged ≥ 7 years. We collected birth and breastfeeding history and determined the population-specific hepatic nuclear factor-1α (HNF-1α) G319S genotype of offspring at age 7 years.
  
  
  RESULTS
  From July 2003 to April 2008, we enrolled 76 offspring of 37 mothers. Sixty-four percent (23/36) of the offspring aged 2-19 years were obese at initial assessment. The rates of obesity remained constant throughout the 5 years. As of April 2008, 7/28 (25%) of the offspring aged 7-19 years have diabetes including 6/14 (43%) aged 10-19 years. Most offspring with diabetes (5/7, 71%) were obese at diagnosis. All of the 7 offspring with diabetes have 1 or 2 copies of the G319S polymorphism.
  
  
  CONCLUSIONS
  The prevalence of type 2 diabetes in this cohort of offspring of First Nation women with pediatric-onset type 2 diabetes is the highest ever reported. Obesity is an important postnatal risk factor for type 2 diabetes in this population and may result from a unique gene-environment interaction.
authors.affiliation: Section of Endocrinology and Metabolism, Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Mendelson
authors.forename: Justin
authors.initials: J
authors.lastname: Cloutier
authors.forename: Louise
authors.initials: L
authors.lastname: Spence
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sellers
authors.forename: Shayne
authors.initials: S
authors.lastname: Taback
authors.forename: Heather
authors.initials: H
authors.lastname: Dean
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000886:Anthropometry; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000235:genetics; D005240:Feasibility Studies; D005260:Female; D005820:Genetic Testing; D005838:Genotype; D051538:Hepatocyte Nuclear Factor 1-alpha / Q000235:genetics*; D006801:Humans; D007198:Indians, North American; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008403:Mass Screening; D011110:Polymorphism, Genetic; D011159:Population Surveillance; D011247:Pregnancy; D055815:Young Adult
chemical_list: D051538:Hepatocyte Nuclear Factor 1-alpha