The effect of physical activity on metabolic syndrome in pregnancy and fetal outc

体力活动对妊娠期代谢综合征及胎儿结局的影响

• 批准号: 7431608
• 负责人: CYNTHIA W KO
• 金额: $ 12.07万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7431608
• 关键词: Adipose tissue; Attenuated; Body mass index; Cardiovascular Diseases; Central obesity; Cirrhosis; Deposition; Development; Diabetes Mellitus; Exercise; Fasting; Fatty acid glycerol esters; Feasibility Studies; Fetal Development; Future; Gestational Diabetes; Glucose; Growth; Health; Hepatocyte; High Density Lipoprotein Cholesterol; Hypertension; Hypertriglyceridemia; Infant Health; Inflammation; Insulin; Insulin Resistance; Intra-abdominal; Lead; Leptin; Link; Lipids; Liver diseases; Maternal Health; Measures; Metabolic; Metabolic syndrome; Methods; Morbidity - disease rate; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Outcome Study; Overweight; Parents; Physical activity; Physiological; Physiological Adaptation; Pilot Projects; Postpartum Period; Predisposing Factor; Pregnancy; Pregnant Women; Prevalence; Public Health; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Risk Factors; Serum; Staging; Structure; Syndrome; United States; Waist-Hip Ratio; Weight Gain; Weight maintenance regimen; Woman; fetal; impaired glucose tolerance; improved; insulin sensitivity; men; mortality; non-alcoholic fatty liver; programs; sedentary; waist circumference

DESCRIPTION (provided by applicant): Overweight and obesity are increasing public health concerns in the United States. A correlate of overweight and obesity, the metabolic syndrome, is a significant risk factor for cardiovascular disease, diabetes mellitus, and is a risk factor for increased all-cause mortality. Central adiposity, as measured by waist circumference or waist-hip ratio, is a key factor predisposing to the metabolic syndrome. One potential underlying pathogenic factor for the metabolic syndrome is insulin resistance. During pregnancy, insulin sensitivity is decreased, frequently leading to the development of gestational diabetes. Gestational diabetes is associated with significant increases in maternal complications and fetal morbidity, as well as being a risk factor for later development of type II diabetes mellitus. Physical activity during pregnancy may be beneficial in increasing insulin sensitivity and in managing gestational diabetes. Weight gained during pregnancy, at least in part due to increases in insulin resistance, is commonly retained after pregnancy and may lead to future overweight, obesity, and the metabolic syndrome. In men and non- pregnant women, physical activity may lead to decreases in central adiposity and improvement in insulin sensitivity. We hypothesize that increasing physical activity during pregnancy may attenuate the increases in central adiposity and the physiological decrease in insulin sensitivity during pregnancy, potentially leading to improved metabolic parameters both during and after pregnancy and improved maternal and fetal outcomes. We propose pilot studies, linked to an ongoing randomized controlled trial of exercise in pregnancy, to inform a larger study of these outcomes. The specific aims of this study are: 1) to determine whether a structured program of moderate to vigorous exercise in pregnancy leads to decreased central adiposity in the postpartum; and 2) to examine the feasibility of studying fetal outcomes in the parent randomized trial. This study will be important in finding methods to help women avoid excessive weight gain during and after pregnancy, and in reducing the long-term potential health effects of pregnancy. It may offer a safe and readily available method to control weight and improve infant health during and after pregnancy.

描述(由申请人提供)： 在美国，超重和肥胖正在加剧公众对健康的担忧。超重和肥胖相关的代谢综合征是心血管疾病和糖尿病的重要风险因素，也是全因死亡率增加的风险因素。中心性肥胖，通过腰围或腰臀比来衡量，是易患代谢综合征的关键因素。代谢综合征的一个潜在致病因素是胰岛素抵抗。在怀孕期间，胰岛素敏感性降低，经常导致妊娠期糖尿病的发生。妊娠期糖尿病与产妇并发症和胎儿发病率的显著增加有关，也是后来发展为II型糖尿病的一个危险因素。孕期体力活动可能有益于提高胰岛素敏感性和管理妊娠期糖尿病。怀孕期间增加的体重，至少部分是由于胰岛素抵抗的增加，通常在怀孕后保留下来，可能会导致未来的超重、肥胖和代谢综合征。在男性和非怀孕女性中，体育活动可能会导致中心性肥胖的减少和胰岛素敏感性的改善。我们假设，孕期增加体力活动可能会减缓中心性肥胖的增加和孕期胰岛素敏感性的生理性下降，潜在地导致孕期和孕后代谢参数的改善，并改善母婴结局。我们建议进行试验性研究，与正在进行的怀孕期间锻炼的随机对照试验相联系，以告知更大规模的研究这些结果。这项研究的具体目的是：1)确定在怀孕期间进行有组织的中等到剧烈运动是否能减少产后中心性肥胖症；2)检查在父母随机试验中研究胎儿结局的可行性。这项研究将有助于找到方法，帮助妇女避免在怀孕期间和怀孕后体重过度增加，并减少怀孕对健康的长期潜在影响。它可能提供一种安全和容易获得的方法来控制体重，改善怀孕期间和怀孕后的婴儿健康。