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, impaired glucose tolerance, and serum lipids in offspring and whether these parameters correlate with metabolism during pregnancy. Study design: Body mass index, BP, serum glucose, and insulin during an oral glucose tolerance test, and lipid concentrations were measured in 99 offspring 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/m²) and had higher systolic (8 mm Hg) and mean arterial BP (4 mm Hg) but similar diastolic BP compared with the control group. ODM had higher 2-hour 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 cholesterol (4.01 ± 0.80 vs 4.40 ± 0.78 mmol/L). In both groups body mass index, triglycerides, and fasting and 2-hour glucose concentrations showed correlations with BP measurements. Fasting insulin was correlated with BP readings only in the ODM. Correlations were found between second- and third- trimester maternal free fatty acid concentrations and diastolic and mean arterial BP. Third-trimester β-hydroxybutyrate was correlated with mean arterial BP. Conclusions: In ODM, abnormalities in weight and glucose tolerance are associated with abnormal maternal metabolism. Higher BP is an additional abnormality associated with fetal overnutrition.