Dabelea D, Pettitt D J, Hanson R L, Imperatore G, Bennett P H, Knowler W C
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona 85014, USA.
Diabetes Care. 1999 Jun;22(6):944-50. doi: 10.2337/diacare.22.6.944.
To investigate the mechanisms underlying the association between birth weight and type 2 diabetes in a population-based study of 3,061 Pima Indians aged 5-29 years.
Glucose and insulin concentrations were measured during a 75-g oral glucose tolerance test, and insulin resistance was estimated according to the homeostatic model (homeostasis model assessment-insulin resistance [HOMA-IR]). Relationships between birth weight, height, weight, fasting and postload concentrations of glucose and insulin, and HOMA-IR were examined with multiple regression analyses.
Birth weight was positively related to current weight and height (P < 0.0001, controlled for age and sex, in each age-group). The 2-h glucose concentrations showed a U-shaped relationship with birth weight in subjects > 10 years of age, and this relation was independent of current body size. In 2,272 nondiabetic subjects, after adjustment for weight and height, fasting and 2-h insulin concentrations and HOMA-IR were negatively correlated with birth weight.
Low-birth-weight Pimas are thinner at ages 5-29 years, yet they are more insulin resistant relative to their body size than those of normal birth weight. By contrast, those with high birth weight are more obese but less insulin resistant relative to their body size. The insulin resistance of low-birth-weight Pima Indians may explain their increased risk for type 2 diabetes.
在一项针对3061名年龄在5至29岁的皮马印第安人的人群研究中，探究出生体重与2型糖尿病之间关联的潜在机制。
在75克口服葡萄糖耐量试验期间测量血糖和胰岛素浓度，并根据稳态模型（稳态模型评估-胰岛素抵抗[HOMA-IR]）估算胰岛素抵抗。通过多元回归分析研究出生体重、身高、体重、空腹和负荷后血糖及胰岛素浓度与HOMA-IR之间的关系。
出生体重与当前体重和身高呈正相关（在每个年龄组中，经年龄和性别校正后，P<0.0001）。在10岁以上的受试者中，2小时血糖浓度与出生体重呈U形关系，且这种关系独立于当前体型。在2272名非糖尿病受试者中，在调整体重和身高后，空腹和2小时胰岛素浓度以及HOMA-IR与出生体重呈负相关。
低出生体重的皮马人在5至29岁时体型较瘦，但相对于其体型，他们比正常出生体重的人更具胰岛素抵抗性。相比之下，高出生体重的人皮马人更肥胖，但相对于其体型，胰岛素抵抗性较低。低出生体重的皮马印第安人的胰岛素抵抗可能解释了他们患2型糖尿病风险增加的原因。
