Maternal obesity, diabetes mellitus and cord blood biomarkers in large-for-gestational age infants.
Maternal obesity, diabetes mellitus and cord blood biomarkers in large-for-gestational age infants.
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DOI：
10.1055/s-0036-1586378
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发表时间：
2010-01-01
期刊：
影响因子：
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通讯作者：
Wang X
中科院分区：
文献类型：
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作者：
Mestan K;Ouyang F;Matoba N;Pearson C;Ortiz K;Wang X
大于胎龄儿（LGA）出生的婴儿有早期儿童肥胖的风险。本研究的目的是调查与LGA状态相关的因素及其与出生时LGA婴儿所涉及的炎症生物标志物的关系。纳入364对母婴，作为波士顿医学中心（BMC）正在进行的婴儿出生体重纵向队列研究的一部分。LGA定义为BMC时出生体重（BW）≥参考人群的第90百分位数（N=45）。合适胎龄（阿加）定义为BW第<90th and >10百分位数（N=319）。脐带血IL-6、IL-8、TNF-α和RANTES水平从使用多重免疫测定法测量的更大组免疫生物标志物中进行分析。多变量回归模型用于确定LGA状态、母亲BMI和糖尿病（DM）（包括妊娠期或2型糖尿病（T2 DM））以及脐带血生物标志物之间的相关性，并对重要的人口统计学和临床变量进行调整。母亲孕前BMI在肥胖范围内（≥30 kg/m2）以及DM均与LGA风险增加相关（OR=2.64，95%CI 1.31-6.20; OR=5.58，95%CI 2.06-15.13）。在4种生物标志物中，只有由白色脂肪组织分泌的趋化因子RANTES（活化调节、正常T细胞表达和摄取后分泌）在LGA婴儿中显著增加（β系数=0.37; 95%CI：0.09，0.65; P<0.01）。在校正母体DM和BMI后，这种关联基本保持不变（β系数=0.37; 95%CI：0.08，0.65; P=0.01）。体重指数（PI=BW×100/身长3）与RANTES呈正相关。巨大儿脐血RANTES选择性升高，与母体因素无关。RANTES作为LGA和未来儿童健康的标志物的进一步研究是必要的。
Infants born large-for-gestational age (LGA) are at risk for early childhood obesity. The aims of this study were to investigate factors associated with LGA status and their relationship to inflammatory biomarkers that have been implicated in the LGA infant at birth. Included were 364 mother-infant pairs enrolled as part of an ongoing longitudinal cohort study of infant birth weight being conducted at Boston Medical Center (BMC). LGA was defined as birth weight (BW) ≥90th percentile of the reference population at BMC (N=45). Appropriate-for-gestational age (AGA) was defined as BW<90th and >10th percentile (N=319). Cord blood IL-6, IL-8, TNF-alpha and RANTES levels were analyzed from a larger panel of immune biomarkers measured using multiplex immunoassay. Multivariate regression models were used to determine the associations between LGA status, maternal BMI and diabetes (DM), which included either gestational or type 2 diabetes (T2DM), and cord blood biomarkers, with adjustment for important demographic and clinical variables. Maternal pre-pregnancy BMI within the obesity range (≥30 kg/m2), as well as DM, were each associated with increased risk of LGA (OR=2.64, 95%CI 1.31-6.20; OR=5.58, 95%CI 2.06-15.13, respectively). Among the 4 biomarkers, only RANTES (regulated on activation, normal T cell express and secreted upon uptake), which is a chemokine secreted by white adipose tissue, was significantly increased in LGA infants (beta-coefficient=0.37; 95% CI: 0.09, 0.65; P<0.01). This association remained essentially unchanged after adjustment for maternal DM and BMI (beta-coefficient=0.37; 95% CI: 0.08, 0.65; P=0.01). Ponderal index (PI=BW×100/length3) was also positively correlated with RANTES. Cord blood RANTES is selectively elevated with fetal macrosomia, independent of maternal factors. Further investigation of RANTES as a marker of LGA and future childhood health is warranted.