The Danish Twin Registry, Department of Epidemiology, University of Southern Denmark, JB Winsløvsvej 9, Odense C, Denmark.
Diabetologia. 2012 Dec;55(12):3204-12. doi: 10.1007/s00125-012-2695-x. Epub 2012 Sep 7.
AIMS/HYPOTHESIS: Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment.
Among 77,885 twins in the Danish Twin Registry, 155 of the most BW-discordant MZ twin pairs (median BW difference 0.5 kg) were assessed using a 2 h oral glucose tolerance test with sampling of plasma (p-)glucose, insulin, C-peptide, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. HOMA for beta cell function (HOMA-β) and insulin resistance (HOMA-IR), and also insulin sensitivity index (BIGTT-SI) and acute insulin response (BIGTT-AIR), were calculated. Subgroup analyses were performed in those with: (1) double verification of BW difference; (2) difference in BW >0.5 kg; and (3) no overt metabolic disease (type 2 diabetes, hyperlipidaemia or thyroid disease).
No intra-pair differences in p-glucose, insulin, C-peptide, incretin hormones, HOMA-β, HOMA-IR or BIGTT-SI were identified. p-Glucose at 120 min was higher in the twins with the highest BW without metabolic disease, and BIGTT-AIR was higher in those with the highest BW although not in pairs with a BW difference of >0.5 kg.
CONCLUSIONS/INTERPRETATION: BW-discordant MZ twins provide no evidence for a detrimental effect of low BW on glucose metabolism in adulthood once genetic factors and rearing environment are controlled for.
目的/假设：低出生体重（BW）与 2 型糖尿病风险增加有关。我们比较了成人 BW 不一致的同卵（MZ）双胞胎的葡萄糖代谢，从而控制了遗传因素和养育环境。
在丹麦双胞胎登记处的 77885 对双胞胎中，根据 BW 差异（中位数 0.5kg），评估了 155 对 BW 差异最大的 MZ 双胞胎，使用 2 小时口服葡萄糖耐量试验，采集血浆（p-）葡萄糖、胰岛素、C 肽、葡萄糖依赖性胰岛素释放肽和胰高血糖素样肽-1。计算了 HOMA 胰岛β细胞功能（HOMA-β）和胰岛素抵抗（HOMA-IR），以及胰岛素敏感性指数（BIGTT-SI）和急性胰岛素反应（BIGTT-AIR）。在以下人群中进行了亚组分析：（1）BW 差异的双重验证；（2）BW 差异>0.5kg；（3）无明显代谢疾病（2 型糖尿病、高脂血症或甲状腺疾病）。
在 p-葡萄糖、胰岛素、C 肽、肠促胰岛素激素、HOMA-β、HOMA-IR 或 BIGTT-SI 方面，双胞胎之间没有差异。在没有代谢疾病的双胞胎中，BW 最高的一组 120 分钟时 p-葡萄糖较高，而 BIGTT-AIR 较高的是 BW 最高的一组，尽管在 BW 差异>0.5kg 的双胞胎中没有这种情况。
结论/解释：控制遗传因素和养育环境后，BW 不一致的 MZ 双胞胎没有证据表明低 BW 对成人期葡萄糖代谢有不良影响。
