Sobrepeso na adolescência de filhos de mães que tiveram distúrbios glicêmicos na gestação / Overweight in adolescent offspring of women with hyperglycemia during pregnancy

OBJETIVO: Observar se diferentes graus de hiperglicemia durante a gestação determinam diferentes freqüências de obesidade e suas comorbidades na adolescência dos filhos. MÉTODOS: Participaram 73 filhos distribuídos em três grupos, segundo a tolerância à glicose materna: G1 (n = 27) teste oral de tolerância à glicose (TOTG) e glicemia diária (GD) normais; G2 (n = 23) TOTG normal e GD elevada; G3 (n = 23) TOTG e GD alterados (diabetes melito ges tacional - DMG). Todos foram submetidos à avaliação clínica (antropometria), a um questionário (dados neonatais, hábitos alimentares) e a dosagem basal de glicose e perfil lipídico sérico. A comparação entre os grupos foi feita por análise de variância e teste de Goodman. RESULTADOS: As mães G3 apresentaram glicemia de jejum (GJ) e GD mais elevadas que as G2 e G1 (GJ: 98 ± 10 versus 83 ± 5 versus 78 ± 10 mg/dL; GD: 104 ± 12 versus 93 ± 7 versus 85 ± 9 mg/dL, respectivamente; p < 0,001). As mães G2 apresentaram GD mais elevada que as G1 (93 ± 7 versus 85 ± 9 mg/dL; p < 0,001). O peso de nascimento (PN) dos filhos G3 foi mais elevado que o dos G2 e G1 (3.667 ± 527 versus 3.167 ± 565 e 3.282 ± 401 g, respectivamente; p < 0,05). Os filhos G3 apresentaram maior freqüência de sobrepeso que os G1 (52,2 versus 14,8 por cento; p < 0,05). CONCLUSÕES: Mães com DMG, apresentando GJ e GD elevadas, têm filhos com maior PN e maior freqüência de sobrepeso na adolescência. Esses filhos precisam ser acompanhados desde a infância.

AIM: To verify whether different hyperglycemia levels during pregnancy cause frequency differences in adolescent obesity and its morbidities in the offspring. METHODS: Seventy-three children were divided into three groups according to maternal glucose tolerance: G1 (n=27) normal oral glucose tolerance test (OGTT) and daily glycemia (DG); G2 (n=23) normal OGTT and high DG; G3 (n=23) abnormal OGTT and DG (gestational diabetes mellitus; GDM). All underwent clinical evaluation (anthropometry) a questionnaire(neonatal data, eating habits), and determination of fasting serum glucose and lipid profile measurement. Analysis of variance (ANOVA) and the Goodman’s test were used to compare the groups. RESULTS: G3 mothers showed higher fasting plasma glucose(FPG) and DG than G2 and G1(FPG: 93±10 vs 83±5 vs 78±10mg/dL; DG: 104±12 vs 93±7 vs 85±9mg/dL, respectively; P<0.001). G2 mothers had higher DG than G1 (93±7 vs 85±9mg/dL; P<0.001). G3 offspring birthweight was higher than G1 and G2 (3,667±527 vs 3,167±565 and 3,282±401g, respectively; P<0.05). More G3 offspring were overweight than G1 (52.2 vs 14.8 percent; P<0.05). CONCLUSIONS: Offspring of GDM mothers with fasting and daily hyperglycemia have higher birthweight and overweight frequency in adolescence. These children must be followed up from infancy.

Avaliaçäo cardiovascular de portadoras da síndrome de Ulrich-Turner pela Dopplerecocardiografia e ressonância magnética / Cardiovascular assessment of patients with Ullrich-Turner's Syndrome on Doppler echocardiography and magnetic resonance imaging

OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta). Their ages ranged from 10 to 28 (mean of 16.7) years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100 percent); 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7), mosaics (n=5), and deletions (n=3). No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5 percent to 20 percent, and 6.3 percent to 29 percent, respectively). This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome