Influence of catch-up growth on glucose tolerance and β-cell function in 7-year-old children:: Results from the Birth to Twenty study

Influence of catch-up growth on glucose tolerance and β-cell function in 7-year-old children:: Results from the Birth to Twenty study
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DOI:
10.1542/peds.2007-3147
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发表时间:
2008-06-01
期刊:
影响因子:
8
通讯作者:
Gray, I. Peter
Gray, I. Peter
中科院分区:
医学2区
文献类型:
--
作者:
Crowther, Nigel J.;Cameron, Noel;Gray, I. Peter

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OBJECTIVE.本研究的目的是探讨儿童期不同阶段的追赶性生长对7岁时血糖水平和β细胞功能的影响。对152名7岁儿童进行了口服葡萄糖耐量试验。从出生到7岁的人体测量数据。根据出生至1岁、出生至5岁、出生至7岁的生长率,将儿童分为追赶组、追赶组和正常生长组。在口服葡萄糖耐量试验期间采集空腹和30分钟及120分钟血样,分析葡萄糖、胰岛素、胰岛素原和des-31,32-胰岛素原水平,并计算曲线下面积值。在出生至5岁或出生至7岁之间具有追赶性生长的儿童比具有追赶性生长的儿童具有更大的胰岛素水平曲线下面积。仅在出生至7岁之间具有追赶性生长的儿童比在出生至1岁和出生至7岁之间经历追赶性生长的儿童表现出更高的胰岛素原水平和对葡萄糖更大的胰岛素分泌反应。出生至7岁之间无追赶性生长的低出生体重儿童血糖水平最高,胰岛素生成指数水平最低,而高出生体重和追赶性生长的儿童胰岛素水平最高。极端的出生体重加上极端的产后生长都对儿童的新陈代谢有害。如果追赶性生长也发生在出生到1岁之间,那么出生到7岁之间追赶性生长的负面代谢效应可能会减弱。
OBJECTIVE. The aim of this study was to investigate the effect of catch-up growth occurring at different stages of childhood on glucose levels and beta-cell function at 7 years of age.METHODS. Oral glucose tolerance tests were performed on 152 7-year-old children. Anthropometric data were available from birth to 7 years of age. Children were split into catch-up, catch-down, and normal-growth groups on the basis of growth rates between birth and 1 year, birth and 5 years, and birth and 7 years. Fasting and 30- and 120-minute blood samples collected during the oral glucose tolerance tests were assayed for glucose, insulin, proinsulin, and des-31,32-proinsulin levels, and area-under-the-curve values were calculated.RESULTS. Children with catch-up growth between birth and 5 years or birth and 7 years had greater area-under-the-curve insulin levels than the children with catch-down growth. Children with catch-up growth only between birth and 7 years exhibited higher proinsulin levels and a greater insulin secretory response to glucose than those who experienced catch-up growth between both birth and 1 year and birth and 7 years of age. Low birth weight children with no catch-up growth between birth and 7 years had the highest glucose and lowest insulinogenic index levels, whereas children with high birth weight and catch-up growth had the highest insulin levels.CONCLUSIONS. Extremes of birth weight in conjunction with extremes of postnatal growth are all detrimental to childhood metabolism. The negative metabolic effects of catch-up growth between birth and 7 years may be attenuated if catch-up growth also occurs between birth and 1 year of age.