Fetal macrosomia related to maternal poorly controlled type 1 diabetes strongly impairs serum lipoprotein concentrations and composition

Aims-To determine the effects of fetal macrosomia related to maternal type 1 diabetes on the lipid transport system. Methods-Serum lipoprotein concentrations and composition and lecithin:chole sterol acyltransferase (LCAT) activity were investigated in macrosomic newb orns (mean birth weight, 4650 g; SEM, 90) and their mothers with poorly con trolled type 1 diabetes, in appropriate for gestational age newborns (mean birth weight, 3616 g; SEM, 68) and their mothers with well controlled type 1 diabetes, and macrosomic (mean birth weight, 4555 g; SEM, 86) or appropri ate for gestational age (mean birth weight, 3290 g; SEM, 45) newborns and t heir healthy mothers. Results-In mothers with well controlled type 1 diabetes, serum lipids, apol ipoproteins, and lipoproteins were comparable with those of healthy mothers . Similarly, in their infants, these parameters did not differ from those o f appropriate for gestational age newborns. Serum triglyceride, very low de nsity lipoprotein (VLDL), apolipoprotein B100 (apo B100), and high density lipoprotein (HDL) triglyceride concentrations were higher, whereas serum ap o A-I and HDL, concentrations were lower in mothers with diabetes and poor glycaemic control than in healthy mothers. Their macrosomic newborns had hi gher concentrations in all serum lipids and lipoproteins, with high apo A-I and apo B100 values compared with appropriate for gestational age newborns . In macrosomic infants off healthy mothers, there were no significant diff erences in lipoprotein profiles compared with those of appropriate for gest ational age infants. LCAT activity was similar in both groups of mothers an d newborns. Conclusion-Poorly controlled maternal type 1 diabetes and fetal macrosomia were associated with lipoprotein abnormalities. Macrosomic lipoprotein prof iles related to poor metabolic control of type 1 diabetes appear to have im plications for later metabolic diseases.