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J Clin Endocrinol Metab. 2015 Mar;100(3):986-93. doi: 10.1210/jc.2014-3239. Epub 2014 Dec 5.

Exposure to maternal gestational diabetes is associated with higher cardiovascular responses to stress in adolescent indians.

Author information

1
Epidemiology Research Unit (G.V.K., S.R.V., S.C.K.), CSI Holdsworth Memorial Hospital, Mysore 570021, India; Centre for Cardiovascular Imaging (A.J.), University College London Institute of Cardiovascular Science, London W1T 7HA, United Kingdom; St John's Research Institute (G.V.K., K.S., A.V.K.), St John's National Academy of Health Sciences, Bangalore 560034, India; and Medical Research Council Lifecourse Epidemiology Unit (C.O., C.H.D.F.), University of Southampton, Southampton SO16 6YD, United Kingdom.

Abstract

CONTEXT:

Altered endocrinal and autonomic nervous system responses to stress may link impaired intra-uterine growth with later cardiovascular disease.

OBJECTIVE:

To test the hypothesis that offspring of gestational diabetic mothers (OGDM) have high cortisol and cardiosympathetic responses during the Trier Social Stress Test for Children (TSST-C).

DESIGN:

Adolescents from a birth cohort in India (n = 213; mean age, 13.5 y), including 26 OGDM, 22 offspring of diabetic fathers (ODF), and 165 offspring of nondiabetic parents (controls) completed 5 minutes each of public speaking and mental arithmetic tasks in front of two unfamiliar "evaluators" (TSST-C). Salivary cortisol concentrations were measured at baseline and at regular intervals after the TSST-C. Heart rate, blood pressure (BP), stroke volume, cardiac output, and total peripheral resistance were measured continuously at baseline, during the TSST-C, and for 10 minutes after the test using a finger cuff; the beat-to-beat values were averaged for these periods.

RESULTS:

Cortisol and cardiosympathetic parameters increased from baseline during stress (P < .001). OGDM had greater systolic BP (mean difference, 5.6 mm Hg), cardiac output (0.5 L/min), and stroke volume (4.0 mL) increases and a lower total peripheral resistance rise (125 dyn · s/cm(5)) than controls during stress. ODF had greater systolic BP responses than controls (difference, 4.1 mm Hg); there was no difference in other cardiosympathetic parameters. Cortisol responses were similar in all three groups.

CONCLUSIONS:

Maternal diabetes during pregnancy is associated with higher cardiosympathetic stress responses in the offspring, which may contribute to their higher cardiovascular disease risk. Further research may confirm stress-response programming as a predictor of cardiovascular risk in OGDM.

PMID:
25478935
PMCID:
PMC4333036
DOI:
10.1210/jc.2014-3239
[Indexed for MEDLINE]
Free PMC Article

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