Effects of infant birthweight and maternal body mass index in pregnancy on components of the insulin resistance syndrome in China
Effects of infant birthweight and maternal body mass index in pregnancy on components of the insulin resistance syndrome in China
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DOI：
10.7326/0003-4819-132-4-200002150-00002
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发表时间：
2000-02-15
影响因子：
39.2
通讯作者：
Barker, D
中科院分区：
文献类型：
--
作者：
Mi, J;Law, C;Barker, D
背景：出生体重减轻与患胰岛素抵抗综合征的风险增加有关。这种风险的一部分被假设为源于子宫内的营养不良。在从慢性营养不良过渡到营养充足的国家，胰岛素抵抗综合征的患病率增加，因为出生后营养改善比产前营养改善得更快。目的：确定胰岛素抵抗综合征的组成部分是否与胎儿生长减少和母亲营养不良有关。设计：一项非同步的前瞻性研究，研究对象为孕期记录母亲身高和体重的男性和女性。研究对象：627名男性和女性(平均年龄45岁)，他们的母亲的产科记录得到保存。测量：成年后代的血压、血糖水平、胰岛素水平和口服葡萄糖耐量试验中的血脂浓度。结果：在调整性别和当前体重指数后，低出生体重与血糖水平、胰岛素水平、甘油三酯水平和血压升高相关。出生体重每增加L公斤，收缩压降低2.9 mm Hg(95%CI，0.3~5.4 mm Hg)，2小时血糖降低5.1%(CI，0.7%~9.3%)。妊娠早期和晚期孕妇体重指数偏低与成年后代血糖、胰岛素和甘油三酯水平升高相关，但与血压升高无关。结论：孕前孕妇体重偏低和胎儿营养不良可能是导致胰岛素抵抗综合征的部分危险因素。这种风险独立于与成人肥胖相关的风险。在中国这样的发展中国家，改善女孩和年轻妇女的营养状况可能会给后代带来长期好处。
Background: Reduced birthweight is associated with increased risk for the insulin resistance syndrome. Part of this risk is hypothesized to originate from undernutrition in utero. The prevalence of the insulin resistance syndrome increases in countries that undergo the transition from chronic malnutrition to adequate nutrition, when postnatal nutrition improves more rapidly than prenatal nutrition.Objective: To determine whether the components of the insulin resistance syndrome are associated with reduced fetal growth and maternal undernutrition.Design: A nonconcurrent, prospective study of men and women whose mothers' heights and weights were recorded during pregnancy.Setting: Beijing, China.Participants: 627 men and women (mean age, 45 years) whose mothers' obstetric records were preserved.Measurements: Adult offspring's blood pressure, plasma glucose levels, insulin levels, and lipid concentrations during an oral glucose tolerance test. The main explanatory measurements were mothers' body mass index during pregnancy and offspring's birthweight and adult size.Results: After adjustment for sex and current body mass index, low birthweight was associated with elevated plasma glucose levels, insulin levels, triglyceride concentrations, and blood pressure. For every l-kg increase in birthweight, systolic blood pressure decreased by 2.9 mm Hg (95% CI, 0.3 to 5.4 mm Hg) and the 2-hour plasma glucose level decreased by 5.1%(CI, 0.7% to 9.3%). Low maternal body mass index in early and late pregnancy was associated with elevated levels of plasma glucose, insulin, and triglycerides in adult offspring but was not associated with elevated blood pressure.Conclusions: Risk for the insulin resistance syndrome may be partially established through low maternal body mass before pregnancy and consequent fetal undernutrition. This risk is independent of that associated with adult obesity. In developing countries such as China, improved nutrition in girls and young women may offer long-term benefits to offspring.