Newsome C A, Shiell A W, Fall C H D, Phillips D I W, Shier R, Law C M
MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton, UK.
Diabet Med. 2003 May;20(5):339-48. doi: 10.1046/j.1464-5491.2003.00871.x.
To determine the relationship of birth weight to later glucose and insulin metabolism.
Systematic review of the published literature. Data sources were Medline and Embase. Included studies were papers reporting the relationship of birth weight with a measure of glucose or insulin metabolism after 1 year of age, including the prevalence of Type 2 diabetes mellitus (DM). Three reviewers abstracted information from each paper according to specified criteria.
Forty-eight papers fulfilled the criteria for inclusion, mostly of adults in developed countries. Most studies reported an inverse relationship between birth weight and fasting plasma glucose concentrations (15 of 25 papers), fasting plasma insulin concentrations (20 of 26), plasma glucose concentrations 2 h after a glucose load (20 of 25), the prevalence of Type 2 DM (13 of 16), measures of insulin resistance (17 of 22), and measures of insulin secretion (16 of 24). The predominance of these inverse relationships and the demonstration in a minority of studies of other directions of the relationships could not generally be explained by differences between studies in the sex, age, or current size of the subjects. However, the relationship of birth weight with insulin secretion was inconsistent in studies of adults.
The published literature shows that, generally, people who were light at birth have an adverse profile of later glucose and insulin metabolism. This is related to higher insulin resistance, but the relationship to insulin secretion in adults is less clear.
确定出生体重与后期葡萄糖及胰岛素代谢之间的关系。
对已发表文献进行系统综述。数据来源为医学文献数据库(Medline)和荷兰医学文摘数据库(Embase)。纳入的研究为报告出生体重与1岁后葡萄糖或胰岛素代谢指标之间关系的论文,包括2型糖尿病(DM)的患病率。三位评审员根据特定标准从每篇论文中提取信息。
48篇论文符合纳入标准,大多数研究对象为发达国家的成年人。大多数研究报告出生体重与空腹血糖浓度(25篇论文中的15篇)、空腹血浆胰岛素浓度(26篇中的20篇)、葡萄糖负荷后2小时的血浆葡萄糖浓度(25篇中的20篇)、2型糖尿病患病率(16篇中的13篇)、胰岛素抵抗指标(22篇中的17篇)以及胰岛素分泌指标(24篇中的16篇)呈负相关。这些负相关关系占主导,少数研究显示的其他关系方向,一般不能用研究对象的性别、年龄或当前体型差异来解释。然而,在成人研究中,出生体重与胰岛素分泌的关系并不一致。
已发表的文献表明,一般来说,出生时体重较轻的人后期葡萄糖和胰岛素代谢情况较差。这与较高的胰岛素抵抗有关,但与成人胰岛素分泌的关系尚不清楚。