Intrauterine programming of urinary calcium and magnesium excretion in children born to mothers with insulin dependent diabetes mellitus
- 1Department of Paediatric Medicine, St Mary’s Hospital for Women and Children, Manchester, UK
- 2Biostatistics Group, Division of Epidemiology and Health Sciences, University of Manchester, Manchester, UK
- 3Department of Obstetrics and Gynaecology, St Mary’s Hospital for Women and Children
- 4Academic Unit of Child Health, The Medical School, University of Manchester, St Mary’s Hospital for Women and Children
- 5Clinical Radiology, Imaging Science and Biomedical Engineering, The Medical School, University of Manchester
- Correspondence to:
Dr Mughal
Department of Paediatric Medicine, St Mary’s Hospital for Women and Children, Hathersage Road, Manchester M13 0JH, UK; zulf.mughalcmmc.nhs.uk
- Accepted 9 February 2005
Abstract
Background: Offspring of diabetic rats have reduced urinary calcium and magnesium excretion compared with offspring of controls; these differences persist up to16 weeks after birth, a time equivalent to young adulthood in humans.
Objectives: To test the hypothesis that urinary calcium and magnesium excretion would be lower in children born to mothers with insulin dependent diabetes mellitus (ChMIDDM) than those born to non-diabetic mothers.
Methods: Concentrations of calcium, magnesium, sodium, and creatinine were measured in first void spot urine samples collected from 45 (28 male; median age 9.6 years) ChMIDDM and 127 (58 male; median age 11.3 years) controls. Analysis of covariance was used to test for differences in urinary calcium to creatinine ratios (UCa/Cr), magnesium to creatinine ratios (UMg/Cr), and log sodium to creatinine ratios (logUNa/Cr) between controls and ChMIDDM after allowing for the effects of sex and age.
Results: UCa/Cr (difference −0.10, 95% confidence interval (CI) −0.19 to −0.01; p = 0.03) and UMg/Cr (difference −0.15, 95% CI −0.22 to −0.08; p<0.0001) were lower in ChMIDDM than controls. However, logUNa/Cr did not differ between ChMIDDM and controls (difference −0.14, 95% CI −0.33 to 0.05; p = 0.1). The daily estimated intake of magnesium, sodium, and protein were significantly higher and that of calcium non-significantly higher in ChMIDDM than controls. In ChMIDDM, UCa/Cr and UMg/Cr were not related to diabetic control of mothers.
Conclusions: Results of this study provide the first evidence that in humans, as in rats, there is modification of renal Ca and Mg handling in ChMIDDM, which persists well into childhood.
- ChMIDDM, children born to mothers with insulin dependent diabetes mellitus
- Cr, creatinine
- HbA1c, haemoglobin A1c
- IDDM, insulin dependent diabetes mellitus
- SDS, standard deviation scores
- UCa/Cr, urinary calcium to creatinine ratio
- UMg/Cr, urinary magnesium to creatinine ratio
- UNa/Cr, urinary sodium to creatinine ratio
Footnotes
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Competing interests: none declared
