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Submitted on January 4, 2005
Accepted on March 21, 2005
Obesity and Clinical Diabetes Research Section, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ
* To whom correspondence should be addressed. E-mail: jbunt{at}mail.nih.gov.
Context/Objective: Given the increasing rates of both childhood obesity and type 2 diabetes (T2DM), we investigated whether maternal diabetes status during pregnancy is a determinant of risk factors associated with T2DM or cardiovascular disease (CVD) in offspring during childhood.
Design/Participants: Forty-two Pima Indians, aged 7-11 y, were identified retrospectively from maternal oral glucose tolerance tests as offspring of a diabetic pregnancy (22 ODM, 8 M/14 F) or offspring born before the mother developed diabetes (20 PRE, 12 M/8 F).
Setting/Main Outcome measures: Weight, height, body mass index, percent body fat, blood pressure, and fasting concentrations of glucose, insulin, hemoglobin A1c (HbA1c), total cholesterol (TC), triglycerides (TG), and HDL-cholesterol (HDL) were measured while staying in an in-patient Clinical Research Unit and compared in cross-sectional analyses.
Results: After adjustment for age and gender, ODM had significantly higher concentrations of HbA1c (ODM= 5.7 ± 0.4, PRE= 5.0 ± 0.4%, P = 0.002), higher systolic (SBP) blood pressure (ODM = 118 ± 13, PRE = 107 ± 10 mmHg; P = 0.02), and lower concentrations of HDL (ODM= 41 ± 9, PRE= 48 ± 6 mg/dl, P = 0.03) than PRE. Maternal diabetes status during pregnancy persisted as a significant determinant of SBP (
= 7.50, P = 0.03) and HbA1c (=0.43, P = 0.002), independent of age, gender, and percent body fat.
Conclusion: Intrauterine exposure to diabetes is a significant determinant of higher SBP and HbA1c during childhood, independent of adiposity and a genetic predisposition to T2DM. These data suggest that in utero exposure to diabetes confers an additional independent risk for the development of T2DM and/or CVD later in life.
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