Increased Fat Mass and Cardiac Septal Hypertrophy in Newborn Infants of Mothers with Well-Controlled Diabetes during Pregnancy

Åman, Jan; Hansson, U.; Östlund, Ingrid; Wall, Kent; Persson, Bengt

doi:10.1159/000323741

Cited by 61 publications

(61 citation statements)

References 60 publications

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“…The increased incidence of circulatory disorders might be due to cardiac malformations as well as to the increased risk of cardiac hypertrophy in offspring of mothers with type 1 diabetes, a condition that has been reported to normalize in early life (25,26).…”

Section: Discussionmentioning

confidence: 99%

Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

et al. 2015

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OBJECTIVEThis study examined the long-term consequences for offspring born to mothers with pregestational type 1 diabetes regarding mortality, hospital admissions, and medication. We also examined the association between HbA 1c levels during pregnancy and mortality and incidence of hospital admissions. RESEARCH DESIGN AND METHODSWe performed a prospective combined clinical and register-based cohort study comparing mortality, hospital admissions, and use of medication in offspring (n = 1,326) of women with pregestational type 1 diabetes (index children) with matched control subjects (n = 131,884). We also examined the association between HbA 1c levels during pregnancy and mortality and the incidence of hospital admissions. Participants were monitored from birth to the age of 13-21 years. RESULTSOverall mortality was significantly increased for index children (hazard ratio 2.10, 95% CI 1.33-3.30, P = 0.001). The incidence of hospital admissions for index children was significantly increased (incidence rate ratio [IRR] 1.45, 95% CI 1.38-1.53, P < 0.001), and this was the case for all age groups until the age of 15 years. The incidence of hospital admissions among index children was positively associated with maternal HbA 1c before pregnancy and in the first trimester. In addition, the overall use of medication was increased in index children (IRR 1.13, 95% CI 1.07-1.19, P < 0.001). CONCLUSIONSType 1 diabetes during pregnancy has long-term implications on the health of offspring, with increased mortality, incidence of hospital admissions, and use of medication. Among mothers with type 1 diabetes, glycemic regulation is positively associated with incidence of hospital admissions in offspring.Women with type 1 diabetes have an increased risk of adverse pregnancy outcome, including stillbirth, perinatal mortality, and congenital malformations (1-4). However, studies concerning long-term offspring outcome are sparse and results conflicting. Some studies have demonstrated an increased risk of type 2 diabetes and obesity, whereas others have found no association with BMI, glucose, insulin, or

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Section: Discussionmentioning

confidence: 99%

Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

et al. 2015

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“…Current preventative measures focus on glucose control (2). However, women with good glycemic control also have affected infants (1,34,51,64), implicating additional contributing fuels, such as lipids (10,30). The relative contribution of excess circulating lipids to the pathogenesis of cardiac disease in offspring of diabetic pregnancies is not well understood or studied.…”

mentioning

confidence: 99%

“…It is certainly plausible that excess circulating maternal fuels and fetal hyperinsulinemia trigger a similar process in the developing heart. Indeed, infants born to mothers with diabetes and obesity have similar cardiac findings at birth, even when glycemic control is good (1,34,51,64), also suggesting that lipids play an underrecognized role (9,30).…”

mentioning

confidence: 99%

Maternal high-fat diet impairs cardiac function in offspring of diabetic pregnancy through metabolic stress and mitochondrial dysfunction

Mdaki

Larsen

Wachal

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

161

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Offspring of diabetic pregnancies are at risk of cardiovascular disease at birth and throughout life, purportedly through fuel-mediated influences on the developing heart. Preventative measures focus on glycemic control, but the contribution of additional offenders, including lipids, is not understood. Cellular bioenergetics can be influenced by both diabetes and hyperlipidemia and play a pivotal role in the pathophysiology of adult cardiovascular disease. This study investigated whether a maternal high-fat diet, independently or additively with diabetes, could impair fuel metabolism, mitochondrial function, and cardiac physiology in the developing offspring's heart. Sprague-Dawley rats fed a control or high-fat diet were administered placebo or streptozotocin to induce diabetes during pregnancy and then delivered offspring from four groups: control, diabetes exposed, diet exposed, and combination exposed. Cardiac function, cellular bioenergetics (mitochondrial stress test, glycolytic stress test, and palmitate oxidation assay), lipid peroxidation, mitochondrial histology, and copy number were determined. Diabetes-exposed offspring had impaired glycolytic and respiratory capacity and a reduced proton leak. High-fat diet-exposed offspring had increased mitochondrial copy number, increased lipid peroxidation, and evidence of mitochondrial dysfunction. Combination-exposed pups were most severely affected and demonstrated cardiac lipid droplet accumulation and diastolic/systolic cardiac dysfunction that mimics that of adult diabetic cardiomyopathy. This study is the first to demonstrate that a maternal high-fat diet impairs cardiac function in offspring of diabetic pregnancies through metabolic stress and serves as a critical step in understanding the role of cellular bioenergetics in developmentally programmed cardiac disease.

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“…Hipertrofi genellikle makrozomiyle birlikte bulunur. Yüksek fetal insülin seviyesinin, vücutta ve miyokarda yağ ve glikojen depolanmasına yol açtığı ve septal hipertrofiye neden olduğu düşünülmektedir 27 . Hipertrofi, transtorasik EKO inceleme ile uygun bir şekilde değerlendirilebilir.…”

Section: Asimetrik Septal Hipertrofiunclassified

Diyabetik Anne Bebeğinde Görülen Kardiyovasküler Komplikasyonlar

Güvenç¹,

Güzeltaş²

2017

Arşiv Kaynak Tarama Dergisi

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Diabetes mellitus is a condition that has negative effects on fetal development throughout pregnancy and causes metabolic disorders and congenital abnormalities in neonates. The most frequent congenital abnormalities are seen in cardiovascular, gastrointestinal, genitourinary system and central nervous system. The cardiac abnormalities that may develop include ventricular and atrial septal defect, patent ductus arteriosus, asymmetrical septal hypertrophy, large artery transposition, tricuspid atresia and aortic contraction. The infants of diabetic mothers need to be followed up also in respect of congenital heart diseases as of the intrauterine period. In this study, we aimed to evaluate the problems of infants of diabetic mothers and to determine risk factors of mothers during pregnancy.

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Increased Fat Mass and Cardiac Septal Hypertrophy in Newborn Infants of Mothers with Well-Controlled Diabetes during Pregnancy

Cited by 61 publications

References 60 publications

Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

Maternal high-fat diet impairs cardiac function in offspring of diabetic pregnancy through metabolic stress and mitochondrial dysfunction

Diyabetik Anne Bebeğinde Görülen Kardiyovasküler Komplikasyonlar

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