Correlations between the intrauterine metabolic environment and blood pressure in adolescent offspring of diabetic mothers

Objective: To investigate associations between maternal diabetes and blood pressure (BP), obesity, impared glucose tolerance, and serum lipids in off- spring and whether these parameters correlate with metabolism during pregna ncy. Study design: Body mass index, BP, serum glucose, and insulin during an ora l glucose tolerance test, and lipid concentrations were measured in 99 offs pring of diabetic mothers (ODM) and 80 members of a control group. Results: ODM were more obese (body mass index 22.5 +/- 5.6 vs 20.3 +/- 4.0 kg/m(2)) and had higher systolic (8 mm Hg) and mean arterial BP (4 mm Hg) b ut similar diastolic BP compared with the control group. ODM had higher 2-h our glucose (6.6 +/- 1.3 vs 5.7 +/- 0.9 mmol/L) and insulin (580 +/- 544 vs 377 +/- 239 pmol/L) concentrations but lower fasting concentrations of low -density lipoprotein (2.54 +/- 0.67 vs 2.82 +/- 0.70 mmol/L) and total chol esterol (4.01 +/- 0.80 vs 4.40 +/- 0.78 mmol/L). In both groups body mass i ndex, triglycerides, and fasting and 2-hour glucose concentrations showed c orrelations with BP measurements. Fasting insulin was correlated with BP re adings only in the ODM. Correlations were found between second- and third-t rimester maternal free fatty acid concentrations and diastolic and mean art erial BP Third-trimester beta-hydroxybutyrate was correlated with mean arte rial BP. Conclusions: In ODM, abnormalities in weight and glucose tolerance are asso ciated with abnormal maternal metabolism. Higher BP is an additional abnorm ality associated with fetal overnutrition.