Milne E, Royle J A, de Klerk N H, Blair E, Bailey H, Cole C, Attia J, Scott R J, Armstrong B K
Centre for Child Health Research, Telethon Institute for Child Health Research, University of Western Australia, Perth, Western Australia, Australia.
Am J Epidemiol. 2009 Jul 15;170(2):221-8. doi: 10.1093/aje/kwp117. Epub 2009 May 28.
The relation between intrauterine growth and risk of childhood acute lymphoblastic leukemia was investigated in an Australian population-based case-control study that included 347 cases and 762 controls aged <15 years recruited from 2003 to 2006. Information on proportion of optimal birth weight, a measure of the appropriateness of fetal growth, was collected from mothers by questionnaire. Data were analyzed by using logistic regression. Risk of acute lymphoblastic leukemia was positively associated with proportion of optimal birth weight; the odds ratio for a 1-standard-deviation increase in proportion of optimal birth weight was 1.18 (95% confidence interval: 1.04, 1.35) after adjustment for the matching variables and potential confounders. This association was also present among children who did not have a high birth weight, suggesting that accelerated growth, rather than high birth weight per se, is associated with risk of acute lymphoblastic leukemia. Similar associations between proportion of optimal birth weight and acute lymphoblastic leukemia were observed for both sexes and across age groups and leukemia subtypes. Results of this study confirm earlier findings of a positive association between rapidity of fetal growth and subsequent risk of acute lymphoblastic leukemia in childhood, and they are consistent with a role for insulin-like growth factors in the causal pathway.
在一项基于澳大利亚人群的病例对照研究中，调查了宫内生长与儿童急性淋巴细胞白血病风险之间的关系。该研究纳入了2003年至2006年招募的347例病例和762名年龄小于15岁的对照。通过问卷调查从母亲那里收集了关于最佳出生体重比例的信息，这是衡量胎儿生长适宜性的一个指标。采用逻辑回归分析数据。急性淋巴细胞白血病风险与最佳出生体重比例呈正相关；在对匹配变量和潜在混杂因素进行调整后，最佳出生体重比例每增加1个标准差，比值比为1.18（95%置信区间：1.04，1.35）。这种关联在出生体重不高的儿童中也存在，这表明生长加速而非出生体重本身与急性淋巴细胞白血病风险相关。在男女两性、不同年龄组和白血病亚型中，均观察到最佳出生体重比例与急性淋巴细胞白血病之间存在类似关联。本研究结果证实了早期关于胎儿生长速度与儿童期急性淋巴细胞白血病后续风险之间存在正相关的发现，并且与胰岛素样生长因子在因果途径中的作用一致。
