摘要

Relationships of neonatal glycemia and birthweight to antecedent fetal glycemia and insulinemia have been examined in the offspring of 63 insulin-dependent diabetic and 29 nondiabetic mothers. Glycosylated hemoglobin levels in maternal and cord blood were measured by the thiobarbituric acid (TBA) colorimetric technique to estimate antecedent fetal and maternal glycemia; cord serum C-peptide was assayed to estimate fetal insulinemia. Glycosylated hemoglobin levels were significantly elevated in the diabetic mothers and their offspring as compared with controls (P less than 0.001), and maternal and cord blood levels were highly correlated in the diabetic group (r = 0.61, P less than 0.001). Cord serum C-peptide and glycosylated hemoglobin levels tended to be associated (r = 0.43, P less than 0.10). Hypoglycemic infants of diabetic mothers (IDM) had significantly higher glycosylated hemoglobin levels (A443 nm/10 mg hemoglobin hemolysate) in cord blood (0.173 +/- 0.009) than did IDM without hypoglycemia (0.153 +/- 0.005, P less than 0.01). Macrosomic and nonmacrosomic IDM, on the other hand, did not differ as to their glycosylated hemoglobin levels (0.162 +/- 0.005 versus 0.161 +/- 0.006, respectively). The occurrence of hypoglycemia was not associated with that of macrosomia (X2 = 0.24, P greater than 0.10). These data strongly suggest that neonatal hypoglycemia is the result of maternal hyperglycemia in pregnancy and consequent fetal hyperglycemia and hyperinsulinemia. However, maternal hyperglycemia in late pregnancy may not be a sufficient explanation for the development of macrosomia in IDM.

译文

已经在 63 名胰岛素依赖型糖尿病母亲和 29 名非糖尿病母亲的后代中检测了新生儿血糖和出生体重与前期胎儿血糖和胰岛素血症的关系。通过硫代巴比妥酸 (TBA) 比色技术测量母体和脐带血中的糖化血红蛋白水平，以估计前期胎儿和母体的血糖; 通过检测脐带血清 c肽来估计胎儿的胰岛素血症。与对照组相比，糖尿病母亲及其后代的糖化血红蛋白水平显著升高 (P 小于 0.001), 在糖尿病组中，母体和脐带血水平高度相关 (r = 0.61，P 小于 0.001)。脐带血清 c肽和糖化血红蛋白水平趋于相关 (r = 0.43，P 小于 0.10)。糖尿病母亲的低血糖婴儿 (IDM) 在脐带血 (0.173/-0.009) 中有明显较高的糖化血红蛋白水平 (A443 nm/10 mg 血红蛋白溶血素) 比没有低血糖的 IDM (0.153/-0.005，P 小于 0.01)。另一方面，巨大和非巨大 IDM 的糖化血红蛋白水平没有差异 (分别为 0.162/-0.005 和 0.161/-0.006)。低血糖的发生与巨大儿的发生无关 (X2 = 0.24，P 大于 0.10)。这些数据强烈表明，新生儿低血糖症是母亲在怀孕期间高血糖以及随之而来的胎儿高血糖和高胰岛素血症的结果。然而，妊娠晚期母体高血糖可能不是 IDM 巨大儿发展的充分解释。