Yu Mu-Xue, Qiu Xiao-Shan, Feng Su-E, Mo Qing-Ping, Xie Xiao-Ying, Shen Zhen-Yu, Liu Yong-Zhou
Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2011 Jul;45(7):633-8.
To investigate the effect of birth weight and early growth on body fat composition and insulin sensitivity.
The birth and growth data of 258 children of 6 to 7 years old in Guangzhou were collected from Jun.2009 to Feb. 2010. Physical and laboratory examination were preformed, which included body weight, body height and body fat composition index (body mass index (BMI), percentage of body fat (PBF), waist circumference to height ratio (WtHR), etc). Fasting blood glucose and insulin were measured. The homeostasis model assessment model for insulin resistance index (HOMA-IR) was calculated. According to birth weight, the children were divided into three groups from light to heavy: BW-I, BW-II, BW-III group. Then according to change in weight SDS between 0 and 36 months, the children were divided into three groups: changers up (CU), non-changers (NC), changers down (CD) group. The effect of birth weight and early growth on body fat composition and insulin sensitivity were analyzed.
Change in weight SDS between 0 and 36 months was higher in BW-I group (1.06 ± 1.29) than in the BW-II group (-0.19 ± 0.94) and BW-III group (-0.10 ± 1.20) (all P values < 0.01). Birth weight of the CU group ((2.90 ± 0.47) kg) was lower than that of the NC group ((3.22 ± 0.34) kg) and the CD group ((3.57 ± 0.37) kg) (all P values < 0.01). The body fat composition index of BMI, PBF and WtHR were higher in the BW-III group ((16.35 ± 2.13) kg/m(2), (17.03 ± 5.88)%, (0.479 ± 0.033)) than in the BW-I group ((15.46 ± 2.06) kg/m(2), (14.06 ± 5.25)%, (0.459 ± 0.032)) and BW-II group ((15.47 ± 1.58) kg/m(2), (14.09 ± 5.01)%, (0.460 ± 0.025)) (P < 0.01), while there was no significant difference between the BW-I group and the BW-II group (P > 0.05). The body fat composition index of BMI, PBF and WtHR were higher in the CU group ((16.44 ± 2.20) kg/m(2), (16.51 ± 5.78)%, (0.473 ± 0.034)) than in the NC group ((15.62 ± 1.74) kg/m(2), (14.49 ± 5.30)%, (0.463 ± 0.030)) and the CD group ((15.26 ± 1.85) kg/m(2), (14.24 ± 5.54)%, (0.462 ± 0.031)) (all P values < 0.05). In the CU group, BMI, PBF and WtHR were higher in the BW-III-CU group ((18.76 ± 2.56) kg/m(2), (22.19 ± 8.28)%, (0.512 ± 0.029)) than in the BW-I-CU group ((16.04 ± 2.14) kg/m(2), (15.54 ± 5.28)%, (0.467 ± 0.034)) and BW-II-CU group ((16.70 ± 1.36) kg/m(2), (17.12 ± 4.44)%, (0.474 ± 0.017)) (all P values < 0.05), while there was no significant difference between the BW-I-CU group and the BW-II-CU group (P > 0.05). HOMA-IR was higher in the CU group (1.27 ± 0.44) than in the NC group (1.08 ± 0.31) and the CD group (1.00 ± 0.36) (all P values < 0.01). In the CU group, HOMA-IR was higher in the BW-III-CU group (1.69 ± 0.48) than in the BW-I-CU group (1.21 ± 0.41) and the BW-II-CU group (1.27 ± 0.44) (all P values < 0.01), while there was no significant difference between the BW-I-CU and BW-II-CU group (P > 0.05).
According to birth weight tertile, both lower birth weight individuals with more weight change-up growth postnatal early and higher birth weight individuals had greater body fat composition in childhood. They were high-risk people of insulin resistance.
探讨出生体重及早期生长对体脂成分和胰岛素敏感性的影响。
收集2009年6月至2010年2月广州市258名6至7岁儿童的出生及生长数据。进行体格检查和实验室检查，包括体重、身高和体脂成分指标（体重指数（BMI）、体脂百分比（PBF）、腰围身高比（WtHR）等）。测量空腹血糖和胰岛素水平。计算胰岛素抵抗指数的稳态模型评估模型（HOMA-IR）。根据出生体重，将儿童从轻到重分为三组：BW-I组、BW-II组、BW-III组。然后根据0至36个月体重标准差评分（SDS）的变化，将儿童分为三组：体重增加组（CU）、体重无变化组（NC）、体重下降组（CD）。分析出生体重及早期生长对体脂成分和胰岛素敏感性的影响。
BW-I组0至36个月体重SDS的变化（1.06±1.29）高于BW-II组（-0.19±0.94）和BW-III组（-0.10±1.20）（所有P值<0.01）。CU组的出生体重（（2.90±0.47）kg）低于NC组（（3.22±0.34）kg）和CD组（（3.57±0.37）kg）（所有P值<0.01）。BW-III组的BMI、PBF和WtHR体脂成分指标（（16.35±2.13）kg/m²，（17.03±5.88）%，（0.479±0.033））高于BW-I组（（15.46±2.06）kg/m²，（14.06±5.25）%，（0.459±0.032））和BW-II组（（15.47±1.58）kg/m²，（14.09±5.01）%，（0.460±0.025））（P<0.01），而BW-I组和BW-II组之间无显著差异（P>0.05）。CU组的BMI、PBF和WtHR体脂成分指标（（16.44±2.20）kg/m²，（16.51±5.78）%，（0.473±0.034））高于NC组（（15.62±1.74）kg/m²，（14.49±5.30）%，（0.463±0.030））和CD组（（15.26±1.85）kg/m²，（14.24±5.54）%，（0.462±0.031））（所有P值<0.05）。在CU组中，BW-III-CU组的BMI、PBF和WtHR（（18.76±2.56）kg/m²，（22.19±8.28）%，（0.512±0.029））高于BW-I-CU组（（16.04±2.14）kg/m²，（15.54±5.28）%，（0.467±0.034））和BW-II-CU组（（16.70±1.36）kg/m²，（17.12±4.44）%，（0.474±0.017））（所有P值<0.05），而BW-I-CU组和BW-II-CU组之间无显著差异（P>0.05）。CU组的HOMA-IR（1.27±0.44）高于NC组（1.08±0.31）和CD组（1.00±0.36）（所有P值<0.01）。在CU组中，BW-III-CU组的HOMA-IR（1.69±0.48）高于BW-I-CU组（1.21±0.41）和BW-II-CU组（1.27±0.44）（所有P值<0.01），而BW-I-CU组和BW-II-CU组之间无显著差异（P>0.05）。
根据出生体重三分位数，出生体重较低且出生后早期体重增加较多的个体以及出生体重较高的个体在儿童期体脂成分均较高。他们是胰岛素抵抗的高危人群。
