Maternal glycemic index and glycemic load in pregnancy and offspring metabolic health in childhood and adolescence-a cohort study of 68,471 mother-offspring dyads from the Danish National Birth Cohort
Maternal glycemic index and glycemic load in pregnancy and offspring metabolic health in childhood and adolescence-a cohort study of 68,471 mother-offspring dyads from the Danish National Birth Cohort
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DOI：
10.1038/s41430-018-0316-6
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发表时间：
2019-07-01
影响因子：
4.7
通讯作者：
Olsen, Sjurdur F.
中科院分区：
文献类型：
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作者：
Maslova, Ekaterina;Hansen, Susanne;Olsen, Sjurdur F.
背景高血糖指数（GI）和血糖负荷（GL）作为碳水化合物质量和数量的指标，已被发现增加成人代谢结果的风险。碳水化合物的质量是否会影响生命早期的代谢程序尚不清楚。我们在丹麦国家出生队列（DNBC）的68，471对母子中研究了母亲GI和GL与出生后7年内后代体重指数（BMI）的相关性。在一个子队列的后代的临床数据（n = 1234），其中包括608对夫妇暴露于妊娠期糖尿病（GDM），我们还研究了与代谢健康的关系，在9-16 years.Methods产妇GI和GL进行了量化使用中期妊娠的食物频率问卷。我们使用出生体重和身长来计算后代的体重指数。根据WHO参考数据，对5个月、12个月和7岁时的年龄和性别特异性BMI z评分进行标准化。在临床队列中，我们量化了身体成分、HOMA-IR和HOMA-B。结果GI和GL的中位数（IQR）分别为83（63-111）和241（180-333）g/d。我们发现GI（Q4 vs. Q1：1.09，95%CI：1.03，1.15）和GL（Q4 vs. Q1：1.10，95%CI：1.05，1.16）适度增加大于胎龄儿（LGA）的相对风险。在临床子队列中，我们观察到后代HOMA-IR、肥胖和代谢综合征z评分可能增加，母亲GI和GI较高。这些协会之间的GDM暴露的后代更强，但CI包括null value.Conclusion我们发现协会的GI和GL在怀孕与后代LGA。对暴露于GDM的后代的潜在长期益处需要在更大的、有效的研究中得到证实。
Background High glycemic index (GI) and glycemic load (GL) as indicators of carbohydrate quality and quantity have been found to increase risk of metabolic outcomes in adults. Whether carbohydrate quality may influence metabolic programming already in early life is unknown. We examined the association of maternal GI and GL with offspring body mass index (BMI) in the first 7 years of life among 68,471 mother-offspring dyads from the Danish National Birth Cohort (DNBC). In a subcohort of offspring with clinical data (n = 1234) that included 608 dyads exposed to gestational diabetes mellitus (GDM), we also examined the relation to metabolic health at 9-16 years.Methods Maternal GI and GL were quantified using a mid-pregnancy food frequency questionnaire. We used birth weight and length to calculate offspring's ponderal index. Age- and sex-specific BMI z scores at 5 mo, 12 mo, and 7 y were standardized against WHO reference data. In the clinical cohort, we quantified body composition, HOMA-IR, and HOMA-B. We used multivariable mixed linear and Poisson regression to model the associations.Results Median (IQR) of GI and GL were 83 (63-111) and 241 (180-333) g/day, respectively. We found that GI (Q4 vs. Q1:1.09, 95%CI: 1.03, 1.15) and GL (Q4 vs. Q1:1.10, 95%CI: 1.05, 1.16) modestly increased the relative risk of large-for gestational age (LGA). In the clinical sub-cohort, we observed a potential increase in offspring HOMA-IR, adiposity, and metabolic syndrome z score with higher maternal GI and GI. These associations were stronger among the GDM-exposed offspring, but the CI included the null value.Conclusion We found associations of GI and GL in pregnancy with offspring LGA. Potential long-term benefits to offspring exposed to GDM need to be confirmed in larger, well-powered studies.