Markers of maternal and infant metabolism are associated with ventricular dysfunction in infants of obese women with type 2 diabetes

作者：Cade W Todd; Levy Philip T; Tinius Rachel A; Patel Mehgna D; Choudhry Swati; Holland Mark R; Singh Gautam K; Cahill Alison G

来源：Pediatric Research, 2017, 82(5): 768-775.

DOI：10.1038/pr.2017.140

BACKGROUND: To test the hypothesis that infants born to obese women with pre-gestational type 2 diabetes mellitus (IBDMs) have ventricular dysfunction at 1 month that is associated with markers of maternal lipid and glucose metabolism.
METHODS: In a prospective observational study of IBDMs (OB+ DM, n = 25), echocardiographic measures of septal, left (LV) and right ventricular (RV) function, and structure were compared at 1 month of age with those in infants born to OB mothers without DM (OB, n = 24) and to infants born to non-OB mothers without DM (Lean, n = 23). Basal maternal lipid and glucose kinetics and maternal plasma and infant (cord) plasma were collected for hormone and cytokine analyses.
RESULTS: RV, LV, and septal strain measures were lower in the OB+ DM infants compared with those in other groups, without evidence of septal hypertrophy. Maternal hepatic insulin sensitivity, maternal plasma free-fatty-acid concentration, and cord plasma insulin and leptin most strongly predicted decreased septal strain in OB+ DM infants.
CONCLUSION: IBDMs have reduced septal function at 1 month in the absence of septal hypertrophy, which is associated with altered maternal and infant lipid and glucose metabolism. These findings suggest that maternal obesity and DM may have a prolonged impact on the cardiovascular health of their offspring, despite the resolution of cardiac hypertrophy.

• 出版日期2017-11