Catalano Patrick M, Thomas Alicia, Huston-Presley Larraine, Amini Saeid B
Department of Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH 44109, USA.
Am J Obstet Gynecol. 2003 Dec;189(6):1698-704. doi: 10.1016/s0002-9378(03)00828-7.
Because offspring of women with gestational diabetes mellitus have an increased risk of obesity and diabetes mellitus as young adults, our purpose was to characterize body composition at birth in infants of women with gestational diabetes mellitus and normal glucose tolerance.
One hundred ninety-five infants of women with gestational diabetes mellitus and 220 infants of women with normal glucose tolerance had anthropometric measurements and total body electrical conductivity body composition evaluations at birth. Parental demographic, anthropometric, medical and family history data, and diagnostic glucose values were used to develop a stepwise regression model that related to fetal growth and body composition.
There was no significant difference in birth weight (gestational diabetes mellitus [3398+/-550 g] vs normal glucose tolerance [3337+/-549 g], P=.26) or fat-free mass (gestational diabetes mellitus [2962+/-405 g] vs normal glucose tolerance [2975+/-408 g], P=.74) between groups. However, infants of women with gestational diabetes mellitus had significantly greater skinfold measures (P=.0001) and fat mass (gestational diabetes mellitus [436+/-206 g] vs normal glucose tolerance [362+/-198 g], P=.0002) compared with infants of women with normal glucose tolerance. In the gestational diabetes mellitus group, although gestational age had the strongest correlation with birth weight and fat-free mass, fasting glucose level had the strongest correlation with neonatal adiposity.
Infants of women with gestational diabetes mellitus, even when they are average weight for gestational age, have increased body fat compared with infants of women with normal glucose tolerance. Maternal fasting glucose level was the strongest predictor of fat mass in infants of women with gestational diabetes mellitus. This increase in body fat may be a significant risk factor for obesity in early childhood and possibly in later life.
由于妊娠期糖尿病女性的后代在年轻时肥胖和患糖尿病的风险增加，我们的目的是描述妊娠期糖尿病女性和糖耐量正常女性所生婴儿出生时的身体成分特征。
195名妊娠期糖尿病女性的婴儿和220名糖耐量正常女性的婴儿在出生时进行了人体测量和全身电阻抗身体成分评估。利用父母的人口统计学、人体测量学、医学和家族病史数据以及诊断性血糖值建立了一个逐步回归模型，该模型与胎儿生长和身体成分相关。
两组之间出生体重（妊娠期糖尿病组[3398±550 g] vs 糖耐量正常组[3337±549 g]，P = 0.26）或去脂体重（妊娠期糖尿病组[2962±405 g] vs 糖耐量正常组[2975±408 g]，P = 0.74）无显著差异。然而，与糖耐量正常女性的婴儿相比，妊娠期糖尿病女性的婴儿皮褶测量值（P = 0.0001）和脂肪量（妊娠期糖尿病组[436±206 g] vs 糖耐量正常组[362±198 g]，P = 0.0002）显著更高。在妊娠期糖尿病组中，尽管胎龄与出生体重和去脂体重的相关性最强，但空腹血糖水平与新生儿肥胖的相关性最强。
妊娠期糖尿病女性所生婴儿，即使其出生体重为孕龄平均体重，与糖耐量正常女性所生婴儿相比，身体脂肪也有所增加。母亲空腹血糖水平是妊娠期糖尿病女性所生婴儿脂肪量的最强预测指标。这种身体脂肪的增加可能是儿童早期乃至以后生活中肥胖的一个重要危险因素。
