Maternal but Not Paternal Association of Ambulatory Blood Pressure With Albumin Excretion in Young Offspring With Type 1 Diabetes
- M. Loredana Marcovecchio, MD1,
- Paivi H. Tossavainen, MD1,
- Carlo L. Acerini, MD1,
- Timothy G. Barrett, PHD2,
- Julie Edge, MD3,
- Andrew Neil, FRCP4,
- Julian Shield, MD5,
- Barry Widmer, BSC1,
- R. Neil Dalton, PHD6 and
- David B. Dunger, MD1,7
- 1Department of Paediatrics, University of Cambridge, Cambridge, U.K.;
- 2School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, U.K.;
- 3Department of Paediatric Endocrinology and Diabetes, Oxford Children's Hospital, Headington, Oxford, U.K.;
- 4Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, U.K.;
- 5Institute of Child Life and Health, UBHT Education Centre, Bristol, U.K.;
- 6WellChild Laboratory, Evelina Children's Hospital, London, U.K.;
- 7Institute of Metabolic Science, University of Cambridge, Cambridge, U.K.
- Corresponding author: David B. Dunger, dbd25{at}cam.ac.uk.
Abstract
OBJECTIVE Familial predisposition to hypertension has been associated with the development of diabetic nephropathy in adults, but there are limited data in adolescents. Our aim was to assess whether parental ambulatory blood pressure (ABP) was associated with ABP and albumin excretion in young offspring with type 1 diabetes.
RESEARCH DESIGN AND METHODS Twenty-four-hour ABP monitoring was performed in 509 young offspring (mean ± SD age 15.8 ± 2.3 years) with type 1 diabetes, 311 fathers, and 444 mothers. Systolic (SBP) and diastolic blood pressure (DBP) measurements during 24 h, daytime, and nighttime were calculated. Three early morning urinary albumin-to-creatinine ratios (ACRs), A1C, and anthropometric parameters were available for the offspring.
RESULTS All paternal ABP parameters, except for nighttime SBP, were independently related to the offspring's ABP (24-h SBP β = 0.18, 24-h DBP β = 0.22, daytime SBP β = 0.25, daytime DBP β = 0.23, and nighttime DBP β = 0.18; all P < 0.01). Maternal 24-h DBP (β = 0.19, P = 0.004), daytime DBP (β = 0.09, P = 0.04), and nighttime SBP (β = 0.24 P = 0.001) were related to the corresponding ABP parameter in the offspring. Significant associations were found between the offspring's logACR and maternal ABP. The association with 24-h DBP (β = 0.16, P = 0.02), daytime DBP (β = 0.16 P = 0.02), and nighttime DBP (β = 0.15 P = 0.03) persisted even after adjustment for the offspring's ABP. Mothers of offspring with microalbuminuria had higher ABP than mothers of offspring without microalbuminuria (all P < 0.05).
CONCLUSIONS In this cohort, parental ABP significantly influenced offspring blood pressure, therefore confirming familial influences on this trait. In addition, maternal ABP, particularly DBP, was closely related to ACR in the offspring, suggesting a dominant effect of maternal genes or an effect of the intrauterine environment on microalbuminuria risk.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received June 25, 2009.
- Accepted November 8, 2009.
- © 2010 by the American Diabetes Association.
