Low birthweight and metabolic abnormalities in twins with increased susceptibility to Type 2 diabetes mellitus
Low birthweight and metabolic abnormalities in twins with increased susceptibility to Type 2 diabetes mellitus
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DOI：
10.1046/j.1464-5491.2000.00288.x
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发表时间：
2000-05-01
影响因子：
3.5
通讯作者：
Pagano, G
中科院分区：
文献类型：
--
作者：
Bo, S;Cavallo-Perin, P;Pagano, G
目的评估宫内环境因素在决定双胞胎出生体重中的作用，这些双胞胎对糖尿病易感性增加且口服糖耐量试验异常反应不协调，并验证双胞胎内出生体重差异与成人生活中代谢异常的可能关联。方法选择同卵双胞胎46例和异卵双胞胎32例；与同卵双胞胎相比，13例同卵双胞胎中有13例糖耐量减低和/或高胰岛素血症。结果13例MZ不协调双胞胎出生体重明显低于其正常同卵双胞胎(P<；0.001)。当将所有双胞胎分为出生体重最高的和出生体重最低的两组时，后一组中所有OGTT异常的受试者都被发现(P<；0.0001)。与正常的MZ双胞胎相比，OGTT异常和代谢综合征的MZ双胞胎的对内出生体重差异显著。当比较配对内出生体重差异较大的三分位数(大于或等于0.450公斤)和两个较低的三分位数(<；0.450公斤)时，发生代谢综合征的相对风险为8.7%。Logistic回归分析证实，配对内出生体重差异是OGTT和代谢综合征异常反应的显著预测因子。结论这些数据提示环境内因素在决定出生体重方面起着重要作用，并支持这样的假设，即配对内出生体重差异，而不是绝对的低出生体重，是导致成年生活中代谢异常的原因。
Aims To evaluate the role of environmental intra-uterine factors in determining the birthweights of twins with increased susceptibility to diabetes and discordant for abnormal responses to the oral glucose tolerance test (OGTT) and verify the possible association of within-pair birthweight differences and metabolic abnormalities in adult life.Methods Forty-six monozygotic (MZ) and 32 dizygotic (DZ) twins were enrolled; 13 MZ twins were discordant for impaired glucose tolerance (IGT) and/or hyperinsulinaemia compared to their co-twins.Results The 13 MZ discordant twins showed significantly lower birthweights than their normal co-twins (P < 0.001). When dividing all twins in those with the highest birthweights within the couple and those with the lowest, all subjects with abnormal OGTT were found in the latter group (P < 0.0001). Within-pair birthweight difference was significantly higher in MZ twins with abnormal OGTT and the metabolic syndrome compared to normal MZ twins. The relative risk of developing the metabolic syndrome was 8.7 (1.6-46.9) when comparing the higher tertile of within-pair birthweight differences (greater than or equal to 0.450 kg) to the two lower tertiles (< 0.450 kg). Logistic regression analysis confirmed within-pair birthweight difference as a significant predictor of abnormal responses to the OGTT and the metabolic syndrome.Conclusions These data suggest a causative role for environmental intra-uterine factors on the determination of birthweight and support the hypothesis that within-pair birthweight difference, rather than an absolute low birthweight, is responsible for the metabolic abnormalities in the adult life.