The relative contributions of birth weight, weight change, and current weight to insulin resistance in contemporary 5-year-olds - The EarlyBird study
The relative contributions of birth weight, weight change, and current weight to insulin resistance in contemporary 5-year-olds - The EarlyBird study
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DOI：
10.2337/diabetes.51.12.3468
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发表时间：
2002-12-01
期刊：
影响因子：
7.7
通讯作者：
Voss, LD
中科院分区：
文献类型：
--
作者：
Wilkin, TJ;Metcalf, BS;Voss, LD
十多年来，胎儿编程假说告诉我们，胰岛素抵抗及其相关的代谢紊乱是由不良的妊娠环境造成的，而低出生体重是其替代因素。然而，低出生体重现在在工业化社会中并不常见。我们调查了 300 名当代英国儿童的出生体重、“追赶”体重和当前体重与胰岛素抵抗的相关性。 5岁时的胰岛素抵抗与出生体重无关，但与两性的当前体重和体重追赶相关，女孩的相关性更强（r = 0.33，P < 0.001 vs. r = 0.18，P = 0.03），她们本质上比男孩具有更强的胰岛素抵抗能力。体重变化仅与当前体重相关（两性中 r = 0.67，P < 0.01），并且没有改善胰岛素抵抗的预测。最重要的是，出生体重较重的儿童在 5 岁时的胰岛素抵抗是相同的，其体重 SD 评分没有变化，而与当前体重相匹配的较轻出生体重的儿童则经历了所谓的“追赶”（男孩分别为 0.89 和 0.88 个单位，P = 0.96；女孩分别为 1.26 和 1.13 个单位，P = 0.41）。当代儿童的胰岛素抵抗似乎是当前体重过重的结果，而不是低出生体重或体重变化的结果。
For more than a decade, the fetal programming hypothesis has taught that insulin resistance and its associated metabolic disturbances result from poor gestational environment, for which low birth weight is a surrogate. Low birth weight, however, is now uncommon in industrialized societies. We have investigated the relevance of birth weight, "catch-up" weight, and current weight to insulin resistance in 300 contemporary British children. Insulin resistance at 5 years was not related to birth weight but was correlated with current weight and weight catch-up in both sexes, more strongly so in girls (r = 0.33, P < 0.001 vs. r = 0.18, P = 0.03), who were intrinsically more insulin-resistant than boys. Weight change merely co-correlated with current weight (r = 0.67, P < 0.01 in both sexes) and did not improve on the prediction of insulin resistance. Most important, insulin resistance at 5 years was the same in children of heavier birth weight, whose weight SD score had not changed, as in those of lighter birth weight, matched for current weight, who had experienced so-called catch-up (boys 0.89 and 0.88 units, respectively, P = 0.96; girls 1.26 and 1.13 units, P = 0.41). Insulin resistance in contemporary children seems to be a function of excess current weight rather than of low birth weight or change in weight.