Cord blood leptin and adiponectin as predictors of adiposity in children at 3 years of age: a prospective cohort study.
Cord blood leptin and adiponectin as predictors of adiposity in children at 3 years of age: a prospective cohort study.
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DOI：
10.1542/peds.2008-0343
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发表时间：
2009-02
期刊：
影响因子：
8
通讯作者：
Gillman MW
中科院分区：
文献类型：
--
作者：
Mantzoros CS;Rifas-Shiman SL;Williams CJ;Fargnoli JL;Kelesidis T;Gillman MW
瘦素和脂联素是脂肪细胞分泌的调节能量稳态和代谢的激素。由于它们在新生儿期和幼儿期的作用尚不清楚，我们在这项前瞻性队列研究中旨在确定脐带血瘦素和脂联素浓度在多大程度上预测3岁时的肥胖和生长。我们研究了588名参加前瞻性产前队列研究项目Viva的儿童。我们研究了脐带血瘦素和脂联素水平与出生前6个月体重变化、3年循环瘦素和脂联素浓度的关系，以及3岁时以下与肥胖相关的结果：BMI z评分、年龄身高z评分、代表整体肥胖的肱三头肌和肩胛下皮囊厚度总和，以及代表中心肥胖的肩胛下/肱三头肌皮囊比。脐带血瘦素和脂联素与妊娠持续时间和出生体重直接相关。脐带血瘦素水平与出生至6个月之间体重长比、体重年龄比和长度年龄比z分数的变化呈负相关。同样，脐带血脂联素与身高体重和年龄体重z分数的变化呈负相关。在调整了与肥胖相关的几个母婴因素后，脐带血瘦素每增加10 ng/mL，与3年后BMI z评分降低和瘦素水平升高有关，但与皮肤折叠厚度无关。脐带血脂联素每增加10µg/mL， 3年时肩胛下皮褶厚度/肱三头肌皮褶厚度比就会增加。脐带血瘦素水平较低与出生时体型较小有关，但在出生后的前6个月体重增加更为明显，3岁时体重指数较高。脐带血脂联素水平也与胎龄出生体重直接相关，与生命前6个月体重增加负相关，并预测3岁时中枢性肥胖的增加。
Leptin and adiponectin are adipocyte-secreted hormones that regulate energy homeostasis and metabolism. Because their roles in the neonatal period and in early childhood are poorly understood, we aimed in this prospective cohort study to determine the extent to which umbilical cord blood leptin and adiponectin concentrations predict measures of adiposity and growth at 3 years of age. We studied 588 children participating in the prospective prebirth cohort study Project Viva. We examined associations of cord blood leptin and adiponectin levels with weight changes during the first 6 months of life, 3-year circulating leptin and adiponectin concentrations, and the following adiposity-related outcomes at 3 years of age: BMI z score, height-for-age z score, and sums of triceps and subscapular skinfold thicknesses to represent overall adiposity, as well as subscapular/triceps skinfold ratio to represent central adiposity. Cord blood leptin and adiponectin were each directly associated with the duration of gestation and birth weight for gestational age z scores. Cord blood leptin levels were negatively associated with change in weight-for-length, weight-for-age, and length-for-age z scores between birth and 6 months of age. Similarly, cord blood adiponectin was negatively associated with change in weight-for-length and weight-for-age z scores. After adjusting for several maternal and child factors related to obesity, each 10 ng/mL increment of cord blood leptin was associated with a reduction in BMI z score and higher leptin levels at 3 years but not with skinfold thicknesses. Each 10 µg/mL increment of cord blood adiponectin was positively associated with a higher subscapular skinfold thickness/triceps skinfold thickness ratio at 3 years. Lower cord blood leptin levels are associated with smaller size at birth but more pronounced weight gain in the first 6 months of life and higher BMI at 3 years of age. Cord blood adiponectin levels are also directly associated with birth weight for gestational age, inversely associated with weight gain in the first 6 months of life, and predict an increase in central adiposity at age 3 years.
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