Leptin partially mediates the association between early-life nutritional supplementation and long-term glycemic status among women in a Guatemalan longitudinal cohort
Leptin partially mediates the association between early-life nutritional supplementation and long-term glycemic status among women in a Guatemalan longitudinal cohort
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DOI：
10.1093/ajcn/nqaa001
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发表时间：
2020-04-01
影响因子：
7.1
通讯作者：
Stein, Aryeh D.
中科院分区：
文献类型：
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作者：
He, Siran;Ngoc-Anh Le;Stein, Aryeh D.
背景：早期接触改善的营养与糖尿病风险降低但肥胖风险增加相关。瘦素与肥胖呈正相关，具有降血糖作用。目的：我们旨在研究瘦素在早期营养与肥胖和糖尿病风险差异关联中的作用。方法：我们分析了危地马拉儿童时期随机分配接受营养补充剂的队列数据。结果：在1112名年龄(均值+/-SD)44.1+/-4.2岁的研究参与者中，60.6%是女性。心脏代谢疾病很常见：40.2%的女性和19.4%的男性肥胖，53.1%的女性和41.0%的男性患有高血糖或糖尿病。女性瘦素浓度中位数为15.2 ng/m L(10.2-17.3 ng/m L)，男性为2.7 ng/m L(1.3-5.3 ng/m L)。瘦素与BMI呈正相关(女性P=0.6，男性P=0.7)。生命早期营养改善的女性瘦素水平高于非营养女性(95%CI：0.3，5.3 ng/mL)，而空腹血糖则较低(-0.8，0.2 mmol/L，无统计学意义)。生命早期营养改善组的瘦素(-0.7 ng/mL；-2.1，0.8 ng/mL)和空腹血糖(0.2 mm ol/L；-0.5 mm o l/L)与未暴露组相比差异无统计学意义。在女性早期营养与空腹血糖之间的途径中，瘦素起到了34.9%的作用。女性的调解是由胰岛β细胞功能的改善推动的。我们没有观察到男性的调节作用。结论：瘦素介导了女性早期营养的降糖作用，而男性则没有。
Background: Early-life exposure to improved nutrition is associated with decreased risk of diabetes but increased risk of obesity. Leptin positively correlates with adiposity and has glucose-lowering effects. thus it may mediate the association of early-life nutrition and long-term glycemic status.Objectives: We aimed to investigate the role of leptin in the differential association between early-life nutrition and the risks of obesity and diabetes.Methods: We analyzed data from a Guatemalan cohort who were randomly assigned at the village level to receive nutritional supplements as children. We conducted mediation analysis to examine the role of leptin in the associations of early-life nutrition and adult cardiometabolic outcomes.Results: Among 1112 study participants aged (mean +/- SD) 44.1 +/- 4.2 y, 60.6% were women. Cardiometabolic conditions were common: 40.2% of women and 19.4% of men were obese, and 53.1% of women and 41.0% of men were hyperglycemic or diabetic. Median (IQR) leptin concentration was 15.2 ng/mL (10.2-17.3 ng/mL) in women and 2.7 ng/mL (1.3-5.3 ng/mL) in men. Leptin was positively correlated with BMI (Spearman's p was 0.6 in women, 0.7 in men). Women exposed to improved nutrition in early life had 2.8-ng/mL (95% CI: 0.3, 5.3 ng/mL) higher leptin and tended to have lower fasting glucose (-0.8 mmol/L.; -1.8, 0.2 mmol/L, nonsignificant) than unexposed women. There were no significant differences in leptin (-0.7 ng/mL; -2.1, 0.8 ng/mL) or fasting glucose (0.2 mmol/L; -0.5, 0.9 mmol/L) in men exposed to improved nutrition in early life compared with unexposed men. Leptin mediated 34.9% of the pathway between early-life nutrition and fasting glucose in women. The mediation in women was driven by improved pancreatic beta-cell function. We did not observe the mediation effect in men.Conclusions: Leptin mediated the glucose-lowering effect of early-life nutrition in women but not in men.