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Pediatr Res ; 82(5): 768-775, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28604759

RESUMEN

BackgroundTo 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.MethodsIn 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.ResultsRV, 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.ConclusionIBDMs 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.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/complicaciones , Lípidos/sangre , Obesidad/complicaciones , Embarazo en Diabéticas , Efectos Tardíos de la Exposición Prenatal , Disfunción Ventricular Izquierda/etiología , Disfunción Ventricular Derecha/etiología , Función Ventricular Izquierda , Función Ventricular Derecha , Adulto , Biomarcadores/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Ecocardiografía , Femenino , Sangre Fetal/metabolismo , Humanos , Lactante , Recién Nacido , Obesidad/sangre , Obesidad/diagnóstico , Embarazo , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo , Disfunción Ventricular Izquierda/sangre , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Derecha/sangre , Disfunción Ventricular Derecha/diagnóstico por imagen , Disfunción Ventricular Derecha/fisiopatología , Adulto Joven
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