Metabolic parameters and fetal development in offspring of mothers with gestational diabetes

Mulliqi Kotori, Vjosa (2016) Metabolic parameters and fetal development in offspring of mothers with gestational diabetes. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Introduction: Increasing incidence of GDM and LGA births predispose children for obesity related diseases, metabolic syndrome and type 2 Diabetes. Aims: The aim of the study was to investigate the cause of enhanced fetal growth (>90 centiles)in well controlled gestational diabetic pregnancies. Subjects and methods: 37 GDM mothers and 46 healthy control subjects and their newborns participated in the cross sectional study. Blood samples were taken from mother before delivery and from neonates at the time of delivery and tested for concentration of adiponectin, leptin, insulin, c peptide, cholesterol, triglycerides, HDL and LDL cholesterol. Results: Gestational diabetic mothers had significantly higher BMI (first trimester) than a control group (29.6 ±6.0 vs. 23.3 ± 4.3, P<0.0001) and adiponectin concentration were significantly lower in gestational diabetic mothers compared with healthy control subjects (10871.3 ± 5184.2 vs. 13418.9 ± 5148.6, P=0.021). In offspring of GDM concentration of adiponectin (24469.0 ± 10478.8 vs. 45359.6 ± 7592, P=0.0017) is significantly lower in LGA newborns of GDM mothers compared with LGA newborns of healthy control; and concentration of Insulin is significantly higher in AGA (11.3 ±14.1 vs.4.3 ±3.2, P<0.0001) and LGA (12.9 ±6.4 vs. 5.8 ±2.9, P=0.035) newborn of GDM mothers compared with AGA and LGA newborns of healthy control. Conclusions: The findings of this study describe an altered metabolic environment for the fetus even in well controlled GDM mothers. Hyperinsulinemia and hypoadiponectinemia in macrosomic infants are predisposing factors that can contribute in development of obesity related disorder later in their life.

Abstract in Croatian

Uvod: Povećanje učestalosti Diabetesa u trudnoći I makrosomne djece nosi veliki rizik za razvitak bolesti povezane za pretilost kao metabolički sindrom I tip 2 dijabetesa. Ciljevi: Cilj istraživanja je ispitati uzrok pojačanog fetalnog razvitka( > 90 centile ) kod trudnica sa dobrom kontrollom gestacijskog diabetesa. Pacijenti i Metode: 37 trudne žene sa GDM i 46 zdravih trudnoća kao kontrolna grupa I njihova novorodenčad su sudjelovali u istraživanju. Uzorci krvi uzeti su od majke prije poroda i od novorodenih u vrijeme poroda I testirana je koncentracije adiponektina, leptina , insulin , c peptida, kolesterola, triglicerida, HDL i LDL kolesterol. Nalazi: Majke sa diabetesom u trudnoći imaju značajno veći BMI ( prvotromjesečje ) od kontrolne skupine ( 29,6 ± 6,0 vs. 23,3 ± 4,3 , P < 0,0001 ) , a koncentracija adiponektina su značajno niže u Majke sa diabetesom u trudnoći u usporedbi sa zdravim kontrolnim ispitanicima ( 10.871,3 ± 5184,2 vs 13.418,9 ± 5148,6 , P = 0,021 ) . U djece majki sa diabetesom koncentracije adiponektina ( 24.469,0 10.478,8 ± vs 45.359,6 ± 7.592 , P = 0.0017 ) su znatno niže kod LGA djece majki s dijabetesom u usporedbi sa LGA djece zdrave kontrolne grupe ; I koncentracija inzulina je znacajno viša u AGA ( 11,3 ± 14,1 vs.4.3 ± 3,2 , P < 0,0001 ) i LGA ( 12,9 ± 6,4 vs 5,8 ± 2,9 , P = 0,035 ) djece majki s diabetesom u usporedbi sa AGA i LGA djece zdrave kontrolne grupe. Zakljucak: Nalazi ovog istraživanja opisuju metabolicke promjene koje okružuju plod kod dobro kontroliranog diabetesa u trudnoći. Hiperinzulinemija I hypoadiponectinemia u makrosomne dojenčadi su predisponirajući čimbenici koji mogu pridonijeti u razvoju bolesti povezane za pretilosti kasnije u životu.

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