Mi J, Law C, Zhang K L, Osmond C, Stein C, Barker D
Department of Epidemiology, Peking Union Medical College, Beijing, People's Republic of China.
Ann Intern Med. 2000 Feb 15;132(4):253-60. doi: 10.7326/0003-4819-132-4-200002150-00002.
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.
To determine whether the components of the insulin resistance syndrome are associated with reduced fetal growth and maternal undernutrition.
A nonconcurrent, prospective study of men and women whose mothers' heights and weights were recorded during pregnancy.
Beijing, China.
627 men and women (mean age, 45 years) whose mothers' obstetric records were preserved.
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.
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 1-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.
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.
出生体重降低与胰岛素抵抗综合征风险增加相关。部分风险被认为源于子宫内营养不足。在从慢性营养不良向营养充足过渡的国家，当产后营养改善速度快于产前营养时，胰岛素抵抗综合征的患病率会增加。
确定胰岛素抵抗综合征的各组成部分是否与胎儿生长受限和母亲营养不足相关。
一项对母亲孕期身高和体重有记录的男性和女性进行的非同期前瞻性研究。
中国北京。
627名男性和女性（平均年龄45岁），其母亲的产科记录得以保存。
成年子代口服葡萄糖耐量试验期间的血压、血浆葡萄糖水平、胰岛素水平和血脂浓度。主要解释性测量指标为母亲孕期体重指数以及子代出生体重和成年时体型。
在对性别和当前体重指数进行调整后，低出生体重与血浆葡萄糖水平、胰岛素水平、甘油三酯浓度升高及血压升高相关。出生体重每增加1千克，收缩压下降2.9毫米汞柱（95%可信区间为0.3至5.4毫米汞柱），2小时血浆葡萄糖水平下降5.1%（可信区间为0.7%至9.3%）。孕早期和孕晚期母亲低体重指数与成年子代血浆葡萄糖、胰岛素和甘油三酯水平升高相关，但与血压升高无关。
胰岛素抵抗综合征的风险可能部分通过孕前母亲低体重及随之而来的胎儿营养不足而确立。这种风险独立于与成年肥胖相关的风险。在中国等发展中国家，改善女童和年轻女性的营养状况可能会为后代带来长期益处。
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