Fetal exposure to maternal type 1 diabetes is associated with renal dysfunction at adult age

Charbel Abi Khalil, Florence Travert, Sabrina Fetita, François Rouzet, Raphael Porcher, Jean Pierre Riveline, Samy Hadjadj, Etienne Larger, Ronan Roussel, Patrick Vexiau, Dominique Le Guludec, Jean François Gautier, Michel Marre

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Abstract

OBJECTIVE - In animal studies, hyperglycemia during fetal development reduces nephron numbers. We tested whether this observation translates into renal dysfunction in humans by studying renal functional reserve in adult offspring exposed in utero to maternal type 1 diabetes. RESEARCH DESIGN AND METHODS - We compared 19 nondiabetic offspring of type 1 diabetic mothers with 18 offspring of type 1 diabetic fathers (control subjects). Glomerular filtration rate (51Cr-EDTA clearance), effective renal plasma flow (123I-hippurate clearance), mean arterial pressure, and renal vascular resistances were measured at baseline and during amino acid infusion, which mobilizes renal functional reserve. RESULTS - Offspring of type 1 diabetic mothers were similar to control subjects for age (median 27, range 18-41, years), sex, BMI (23.1 ± 3.7 kg/m2), and birth weight (3,288 ± 550 vs. 3,440 ± 489 g). During amino acid infusion, glomerular filtration rate and effective renal plasma flow increased less in offspring of type 1 diabetic mothers than in control subjects: from 103 ± 14 to 111 ± 17 ml/min (8 ± 13%) vs. from 108 ± 17 to 128 ± 23 ml/min (19 ± 7%, P = 0.009) and from 509 ± 58 to 536 ± 80 ml/min (5 ± 9%) vs. from 536 ± 114 to 620 ± 140 ml/min (16 ± 11%, P = 0.0035). Mean arterial pressure and renal vascular resistances declined less than in control subjects: 2 ± 5 vs. -2 ± 3% (P = 0.019) and 3 ± 9 vs. -14 ± 8% (P = 0.001). CONCLUSIONS - Reduced functional reserve may reflect a reduced number of nephrons undergoing individual hyperfiltration. If so, offspring of type 1 diabetic mothers may be predisposed to glomerular and vascular diseases.

Original languageEnglish
Pages (from-to)2631-2636
Number of pages6
JournalDiabetes
Volume59
Issue number10
DOIs
Publication statusPublished - Oct 2010
Externally publishedYes

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ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Abi Khalil, C., Travert, F., Fetita, S., Rouzet, F., Porcher, R., Riveline, J. P., Hadjadj, S., Larger, E., Roussel, R., Vexiau, P., Le Guludec, D., Gautier, J. F., & Marre, M. (2010). Fetal exposure to maternal type 1 diabetes is associated with renal dysfunction at adult age. Diabetes, 59(10), 2631-2636. https://doi.org/10.2337/db10-0419