Gillman Matthew W, Rich-Edwards Janet W, Huh Susanna, Majzoub Joseph A, Oken Emily, Taveras Elsie M, Rifas-Shiman Sheryl L
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA.
Obesity (Silver Spring). 2006 Sep;14(9):1647-53. doi: 10.1038/oby.2006.189.
Animal models suggest that fetal exposure to glucocorticoids can program adiposity, especially central adiposity, later in life. We examined associations of maternal corticotropin-releasing hormone (CRH) levels in the late 2nd trimester of pregnancy, a marker of fetal glucocorticoid exposure, with child adiposity at age 3 years.
We analyzed data from 199 participants in Project Viva, a prospective cohort study of pregnant women and their children, At age 3 years, the main outcomes were age-sex-specific BMI z score and the sum of subscapular (SS) and triceps (TR) skinfold thicknesses to represent overall adiposity, and ratio of SS to TR (SS:TR) to represent central adiposity.
Mean (standard deviation) maternal 2nd trimester log CRH was 4.94 (0.56) pg/mL. At age 3, mean (standard deviation) for BMI z score was 0.52 (1.02); for SS + TR, 16.51 (3.94) mm; and for SS:TR, 0.67 (0.17). Log CRH was mildly inversely correlated with birth weight (r = -0.08), chiefly because of its association with length of gestation (r = -0.21) rather than fetal growth (r = -0.004). After adjustment for sociodemographic factors, maternal smoking, BMI, and gestational weight gain, fetal growth, length of gestation, breastfeeding duration, and (for SS:TR only) child's 3-year BMI, each increment of 1 unit of log CRH was associated with a reduction in BMI z score [-0.43; 95% confidence interval (CI), -0.73, -0.14; p = 0.004] and possible reduction in SS + TR (-1.10; 95% CI, -2.33, 0.14; p = 0.08). In contrast, log CRH was associated with higher SS:TR (0.07; 95% CI, 0.02, 0.13; p = 0.007).
Fetal exposure to glucocorticoids, although associated with an overall decrease in body size, may cause an increase in central adiposity.
动物模型表明，胎儿期暴露于糖皮质激素会影响其成年后的肥胖程度，尤其是腹部肥胖。我们研究了孕期中期晚期母体促肾上腺皮质激素释放激素（CRH）水平（胎儿糖皮质激素暴露的一个标志物）与儿童3岁时肥胖程度之间的关联。
我们分析了来自“活力计划”的199名参与者的数据，这是一项针对孕妇及其子女的前瞻性队列研究。在儿童3岁时，主要结局指标包括按年龄和性别划分的BMI z评分、肩胛下（SS）和肱三头肌（TR）皮褶厚度之和以代表总体肥胖程度，以及SS与TR的比值（SS:TR）以代表腹部肥胖程度。
孕期中期母体CRH的平均（标准差）对数为4.94（0.56）pg/mL。在3岁时，BMI z评分的平均（标准差）为0.52（1.02）；SS + TR为16.51（3.94）mm；SS:TR为0.67（0.17）。CRH对数与出生体重呈轻度负相关（r = -0.08），主要是因为它与妊娠期长度相关（r = -0.21），而非与胎儿生长相关（r = -0.004）。在调整了社会人口学因素、母体吸烟、BMI、孕期体重增加、胎儿生长、妊娠期长度、母乳喂养持续时间以及（仅针对SS:TR）儿童3岁时的BMI后，CRH对数每增加1个单位，与BMI z评分降低相关[-0.43；95%置信区间（CI），-0.73，-0.14；p = 0.004]，且SS + TR可能降低（-1.10；95%CI，-2.33，0.14；p = 0.08）。相比之下，CRH对数与更高的SS:TR相关（0.07；95%CI，0.02，0.13；p = 0.007）。
胎儿期暴露于糖皮质激素，虽然与总体体型减小有关，但可能会导致腹部肥胖增加。
