Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK,
Diabetologia. 2010 Apr;53(4):641-51. doi: 10.1007/s00125-009-1648-5. Epub 2010 Jan 10.
AIMS/HYPOTHESIS: We investigated whether children who are heavier at birth have an increased risk of type 1 diabetes.
Relevant studies published before February 2009 were identified from literature searches using MEDLINE, Web of Science and EMBASE. Authors of all studies containing relevant data were contacted and asked to provide individual patient data or conduct pre-specified analyses. Risk estimates of type 1 diabetes by category of birthweight were calculated for each study, before and after adjustment for potential confounders.Meta-analysis techniques were then used to derive combined ORs and investigate heterogeneity between studies.
Data were available for 29 predominantly European studies (five cohort, 24 case-control studies), including 12,807 cases of type 1 diabetes. Overall, studies consistently demonstrated that children with birthweight from 3.5 to 4 kg had an increased risk of diabetes of 6% (OR 1.06 [95% CI 1.01-1.11]; p=0.02) and children with birthweight over 4 kg had an increased risk of 10% (OR 1.10 [95% CI 1.04-1.19]; p=0.003), compared with children weighing 3.0 to 3.5 kg at birth. This corresponded to a linear increase in diabetes risk of 3% per 500 g increase in birthweight (OR 1.03 [95% CI 1.00-1.06]; p=0.03). Adjustments for potential confounders such as gestational age, maternal age, birth order, Caesarean section, breastfeeding and maternal diabetes had little effect on these findings.
CONCLUSIONS/INTERPRETATION: Children who are heavier at birth have a significant and consistent, but relatively small increase in risk of type 1 diabetes.
目的/假设：我们研究了出生体重较重的儿童是否患 1 型糖尿病的风险增加。
使用 MEDLINE、Web of Science 和 EMBASE 进行文献检索，确定了 2009 年 2 月之前发表的相关研究。联系了所有包含相关数据的研究作者，并要求他们提供个体患者数据或进行预定分析。在调整了潜在混杂因素后，计算了每个研究中按出生体重分类的 1 型糖尿病风险估计值。然后使用荟萃分析技术得出合并 OR 值并研究研究之间的异质性。
共有 29 项主要来自欧洲的研究（5 项队列研究，24 项病例对照研究）提供了数据，其中包括 12807 例 1 型糖尿病病例。总体而言，这些研究一致表明，出生体重在 3.5 至 4 公斤之间的儿童患糖尿病的风险增加 6%（OR 1.06[95%CI 1.01-1.11]；p=0.02），出生体重超过 4 公斤的儿童患糖尿病的风险增加 10%（OR 1.10[95%CI 1.04-1.19]；p=0.003），与出生时体重为 3.0 至 3.5 公斤的儿童相比。这相当于出生体重每增加 500 克，糖尿病风险增加 3%（OR 1.03[95%CI 1.00-1.06]；p=0.03）。对潜在混杂因素（如胎龄、母亲年龄、出生顺序、剖宫产、母乳喂养和母亲糖尿病）进行调整对这些发现影响不大。
结论/解释：出生体重较重的儿童患 1 型糖尿病的风险显著且一致，但相对较小。
