Size at Birth, Weight Gain in Infancy and Childhood, and Adult Diabetes Risk in Five Low- or Middle-Income Country Birth Cohorts
Size at Birth, Weight Gain in Infancy and Childhood, and Adult Diabetes Risk in Five Low- or Middle-Income Country Birth Cohorts
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DOI：
10.2337/dc11-0456
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发表时间：
2012-01-01
期刊：
影响因子：
16.2
通讯作者：
Fall, Caroline H. D.
中科院分区：
文献类型：
--
作者：
Norris, Shane A.;Osmond, Clive;Fall, Caroline H. D.
我们研究了出生体重和婴儿期和幼儿期体重增加与2型糖尿病（DM）风险的关系，研究设计和方法来自低收入和中等收入国家的5个队列，参与者为来自巴西、危地马拉、印度、菲律宾和南非的6,511名年轻人。暴露量为出生时、24个月和48个月时的体重，以及这些年龄段之间的成年体重和条件性体重增加（CWG，与预期体重增加的偏差）。结果为成人空腹血糖、空腹血糖受损或糖尿病（IFG/DM）和胰岛素抵抗稳态模型评估（IR-HOMA，三个队列）ACIDS-出生体重与成人血糖和IFG/DM风险呈负相关（比值比0.91 [95%CI 0.84-0.99]/SD）。24和48个月时的体重以及CWG 0-24和24-48个月与血糖和IFG/DM无关;然而，CWG 48个月成年期与IFG/DM呈正相关（1.32 [1.22-1.43]/SD）。校正成人腰围后，出生体重、24和48个月体重以及0-24个月CWG与血糖和IFG/DM呈负相关。出生体重与IR-HOMA无关，而0-24和24-48个月以及48个月成年期的CWG越大，IR-HOMA越高（均P < 0.001）。调整成人腰围后，出生体重与IR-HOMA.CONCLUSIONS-Lower出生体重和48个月后体重加速增加是成人葡萄糖耐受不良的危险因素。在0到24个月之间加速的体重增加并不能预测葡萄糖耐受不良，但可以预测更高的胰岛素抵抗。
OBJECTIVE-We examined associations of birth weight and weight gain in infancy and early childhood with type 2 diabetes (DM) risk in five cohorts from low- and middle-income countries.RESEARCH DESIGN AND METHODS-Participants were 6,511 young adults from Brazil, Guatemala, India, the Philippines, and South Africa. Exposures were weight at birth, at 24 and 48 months, and adult weight, and conditional weight gain (CWG, deviation from expected weight gain) between these ages. Outcomes were adult fasting glucose, impaired fasting glucose or DM (IFG/DM), and insulin resistance homeostasis model assessment (IR-HOMA, three cohorts).RESULTS-Birth weight was inversely associated with adult glucose and risk of IFG/DM (odds ratio 0.91 [95% CI 0.84-0.99] per SD). Weight at 24 and 48 months and CWG 0-24 and 24-48 months were unrelated to glucose and IFG/DM; however, CWG 48 months adulthood was positively related to IFG/DM (1.32 [1.22-1.43] per SD). After adjusting for adult waist circumference, birth weight, weight at 24 and 48 months and CWG 0-24 months were inversely associated with glucose and IFG/DM. Birth weight was unrelated to IR-HOMA, whereas greater CWG at 0-24 and 24-48 months and 48 months adulthood predicted higher IR-HOMA (all P < 0.001). After adjusting for adult waist circumference, birth weight was inversely related to IR-HOMA.CONCLUSIONS-Lower birth weight and accelerated weight gain after 48 months are risk factors for adult glucose intolerance. Accelerated weight gain between 0 and 24 months did not predict glucose intolerance but did predict higher insulin resistance.