Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus

被引:354
作者
Schaefer-Graf, Ute M. [1 ,2 ]
Graf, Kristof [3 ]
Kulbacka, Irina [1 ]
Kjos, Siri L. [4 ]
Dudenhausen, Joachim [5 ]
Vetter, Klaus [1 ]
Herrera, Emilio [6 ]
机构
[1] Vivantes Med Ctr Berlin Neukoelln, Dept Obstet, Berlin, Germany
[2] St Joseph Hosp, Dept Obstet & Gynecol, Berlin, Germany
[3] German Heart Inst, Berlin, Germany
[4] Harbor UCLA Med Ctr, Dept Obstet & Gynecol, Torrance, CA 90509 USA
[5] Humboldt Univ, Dept Obstet, Charite, Berlin, Germany
[6] Univ San Pablo CEU, Dept Biochem & Mol Biol, Madrid, Spain
关键词
D O I
10.2337/dc08-0039
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - To determine the contribution of maternal glucose and lipids to intrauterine metabolic environment and fetal growth in pregnancies with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS - in 150 pregnancies, serum triglycerides (TGs), cholesterol, free fatty acids (FFAs), glycerol, insulin, and glucose were determined in maternal serum and cord blood during the 3rd trimester. Maternal glucose values came from oral glucose tolerance testing and glucose profiles. Measurements of fetal abdominal circumference (AC) were performed simultaneously with maternal blood sampling and birth weight, and BMI and neonatal fat mass were obtained following delivery. RESULTS - Maternal TGs and FFAs correlated with fetal AC size (at 28 weeks: triglycerides, P = 0.001; FFAs, P = 0.02), and at delivery they correlated with all neonatal anthropometric measures (FFA: birth weight, P = 0.002; BMI, P = 0.001 fat mass, P = 0.01). After adjustment for confounding variables, maternal FFAs and TGs at delivery remained the only parameters independently related to newborns large for gestational age (LGA) (P = 0.008 and P = 0.04, respectively). Maternal FFA levels were higher in mothers with LGA newborns than in those with appropriate for gestational age (AGA) newborns (362.8 +/- 101.7 vs. 252.4 +/- 10. 1, P = 0.002). Maternal levels OF TGs, HAS, and glycerol at delivery correlated with those in cord blood (P = 0,003, P = 0.004, and P = 0.005, respectively). Fetal triglyceride and cholesterol levels were negatively correlated with newborn birth weight (P = 0.001), BMI (P = 0.004), and fat mass (P = 0.001). TGs were significantly higher in small for gestational age (SGA) newborns compared with AGA or LGA newborns, while insulin-to-glucose ratio and FFAs were the highest in LGA newborns. CONCLUSIONS - in well-controlled GDM pregnancies, maternal lipids are strong Predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared with those with appropriate growth.
引用
收藏
页码:1858 / 1863
页数:6
相关论文
共 25 条
[11]   Modified therapy for gestational diabetes using high-risk and low-risk fetal abdominal circumference growth to select strict versus relaxed maternal glycemic targets [J].
Kjos, Siri L. ;
Schaefer-Graf, Ure A. .
DIABETES CARE, 2007, 30 :S200-S205
[12]   PREDICTION OF INFANT BIRTH-WEIGHT BY GDM SCREENING-TESTS - IMPORTANCE OF PLASMA TRIGLYCERIDE [J].
KNOPP, RH ;
MAGEE, MS ;
WALDEN, CE ;
BONET, B ;
BENEDETTI, TJ .
DIABETES CARE, 1992, 15 (11) :1605-1613
[13]   Overweight and obese in gestational diabetes: The impact on pregnancy outcome [J].
Langer, O ;
Yogev, Y ;
Xenakis, EMJ ;
Brustman, L .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2005, 192 (06) :1768-1776
[14]   Impaired serum lipids and lipoproteins in fetal macrosomia related to maternal obesity [J].
Merzouk, H ;
Meghelli-Bouchenak, M ;
Loukidi, B ;
Prost, J ;
Belleville, J .
BIOLOGY OF THE NEONATE, 2000, 77 (01) :17-24
[15]   Low birth weight at term impairs cord serum lipoprotein compositions and concentrations [J].
Merzouk, H ;
Meghelli-Bouchenak, M ;
El-Korso, N ;
Belleville, J ;
Prost, J .
EUROPEAN JOURNAL OF PEDIATRICS, 1998, 157 (04) :321-326
[16]   Maternal and fetal serum lipid and lipoprotein concentrations and compositions in type 1 diabetic pregnancy: Relationship with maternal glycemic control [J].
Merzouk, H ;
Madani, S ;
Korso, N ;
Bouchenak, M ;
Prost, J ;
Belleville, J .
JOURNAL OF LABORATORY AND CLINICAL MEDICINE, 2000, 136 (06) :441-448
[17]   LONGITUDINAL-STUDY OF PLASMA-LIPOPROTEINS AND HORMONES DURING PREGNANCY IN NORMAL AND DIABETIC WOMEN [J].
MONTELONGO, A ;
LASUNCION, MA ;
PALLARDO, LF ;
HERRERA, E .
DIABETES, 1992, 41 (12) :1651-1659
[18]   MATERNAL SERUM TRIGLYCERIDE, GLUCOSE-TOLERANCE, AND NEONATAL BIRTH-WEIGHT RATIO IN PREGNANCY - A STUDY WITHIN A RACIALLY HETEROGENEOUS POPULATION [J].
NOLAN, CJ ;
RILEY, SF ;
SHEEDY, MT ;
WALSTAB, JE ;
BEISCHER, NA .
DIABETES CARE, 1995, 18 (12) :1550-1556
[19]   Fetal cord plasma lipoprotein status in uncomplicated human pregnancies and in pregnancies complicated by pre-eclampsia and intrauterine growth restriction [J].
Rodie, VA ;
Caslake, MJ ;
Stewart, F ;
Sattar, N ;
Ramsay, JE ;
Greer, IA ;
Freeman, DJ .
ATHEROSCLEROSIS, 2004, 176 (01) :181-187
[20]  
Roggenbuck Lennart F, 2004, Clin Lab, V50, P403