Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations with neonatal anthropometrics.
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations with neonatal anthropometrics.
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DOI：
10.2337/db08-1112
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发表时间：
2009-02
期刊：
影响因子：
7.7
通讯作者：
HAPO Study Cooperative Research Group
中科院分区：
文献类型：
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作者：
HAPO Study Cooperative Research Group
目的：在一项多中心多国研究，高血糖和不良妊娠结局（HAPO）研究中，检查新生儿肥胖与母体血糖水平和脐带血清C肽的相关性，从而评估Pederson将母体血糖和胎儿高胰岛素血症与新生儿肥胖联系起来的假设。研究设计和方法-符合条件的孕妇在妊娠24 - 32周（尽可能接近28周）进行标准的75-g口服葡萄糖耐量试验。新生儿体格测量和脐带血C肽测定。采用多元逻辑回归分析评估母体血糖和脐带血清C肽与新生儿肥胖（皮肤皱褶总和>第90百分位数或体脂百分比>第90百分位数）的关系，并调整潜在的混杂因素，包括母体年龄、产次、BMI、平均动脉压、身高、分娩时胎龄和婴儿性别。在23，316名HAPO研究参与者中，血糖水平对护理人员不知情，其中19，885名婴儿的脐带血清C肽结果和19，389名婴儿的皮肤褶皱测量结果可用。对于新生儿肥胖的措施，有很强的统计学显着的梯度增加水平的母体葡萄糖和脐带血清C肽，这仍然存在调整后的潜在混杂因素。在完全校正的连续变量模型中，空腹、1小时和2小时血糖升高1 SD的两种肥胖指标的比值比范围为1.35至1.44。结论：这些发现证实了母体葡萄糖和新生儿肥胖之间的联系，并表明这种关系是由胎儿胰岛素产生介导的，Pedersen假说描述了影响胎儿生长的基本生物学关系。
OBJECTIVE—To examine associations of neonatal adiposity with maternal glucose levels and cord serum C-peptide in a multicenter multinational study, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study, thereby assessing the Pederson hypothesis linking maternal glycemia and fetal hyperinsulinemia to neonatal adiposity. RESEARCH DESIGN AND METHODS—Eligible pregnant women underwent a standard 75-g oral glucose tolerance test between 24 and 32 weeks gestation (as close to 28 weeks as possible). Neonatal anthropometrics and cord serum C-peptide were measured. Associations of maternal glucose and cord serum C-peptide with neonatal adiposity (sum of skin folds >90th percentile or percent body fat >90th percentile) were assessed using multiple logistic regression analyses, with adjustment for potential confounders, including maternal age, parity, BMI, mean arterial pressure, height, gestational age at delivery, and the baby's sex. RESULTS—Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, cord serum C-peptide results were available for 19,885 babies and skin fold measurements for 19,389. For measures of neonatal adiposity, there were strong statistically significant gradients across increasing levels of maternal glucose and cord serum C-peptide, which persisted after adjustment for potential confounders. In fully adjusted continuous variable models, odds ratios ranged from 1.35 to 1.44 for the two measures of adiposity for fasting, 1-h, and 2-h plasma glucose higher by 1 SD. CONCLUSIONS—These findings confirm the link between maternal glucose and neonatal adiposity and suggest that the relationship is mediated by fetal insulin production and that the Pedersen hypothesis describes a basic biological relationship influencing fetal growth.