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母体胰岛素抵抗、甘油三酯和脐带血胰岛素与后代出生后 2 年内的体重轨迹和身体成分的关系。

Maternal insulin resistance, triglycerides and cord blood insulin in relation to post-natal weight trajectories and body composition in the offspring up to 2 years.

机构信息

Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

出版信息

Diabet Med. 2013 Dec;30(12):1500-7. doi: 10.1111/dme.12298. Epub 2013 Sep 11.

Abstract

AIMS

The intrauterine metabolic environment might have a programming effect on offspring body composition. We aimed to explore associations of maternal variables of glucose and lipid metabolism during pregnancy, as well as cord blood insulin, with infant growth and body composition up to 2 years post-partum.

METHODS

Data of pregnant women and their infants came from a randomized controlled trial designed to investigate the impact of nutritional fatty acids on adipose tissue development in the offspring. Of the 208 pregnant women enrolled, 118 infants were examined at 2 years. In the present analysis, maternal fasting plasma insulin, homeostasis model assessment of insulin resistance and serum triglycerides measured during pregnancy, as well as insulin in umbilical cord plasma, were related to infant growth and body composition assessed by skinfold thickness measurements and abdominal ultrasonography up to 2 years of age.

RESULTS

Maternal homeostasis model assessment of insulin resistance at the 32nd week of gestation was significantly inversely associated with infant lean body mass at birth, whereas the change in serum triglycerides during pregnancy was positively associated with ponderal index at 4 months, but not at later time points. Cord plasma insulin correlated positively with birthweight and neonatal fat mass and was inversely associated with body weight gain up to 2 years after multiple adjustments. Subsequent stratification by gender revealed that this relationship with weight gain was stronger, and significant only in girls.

CONCLUSIONS

Cord blood insulin is inversely associated with subsequent infant weight gain up to 2 years and this seems to be more pronounced in girls.

摘要

目的

宫内代谢环境可能对后代的身体成分具有编程效应。我们旨在探讨妊娠期间母体葡萄糖和脂质代谢的变量以及脐血胰岛素与婴儿生长和产后 2 年内身体成分的关系。

方法

孕妇及其婴儿的数据来自一项旨在研究营养脂肪酸对后代脂肪组织发育影响的随机对照试验。在纳入的 208 名孕妇中,有 118 名婴儿在 2 岁时接受了检查。在本分析中,妊娠期间测量的空腹血浆胰岛素、稳态模型评估的胰岛素抵抗和血清甘油三酯以及脐血血浆胰岛素与通过皮褶厚度测量和腹部超声评估的婴儿生长和身体成分有关,直至 2 岁。

结果

妊娠 32 周时的母体稳态模型评估的胰岛素抵抗与出生时婴儿的瘦体重呈显著负相关,而妊娠期间血清甘油三酯的变化与 4 个月时的体质指数呈正相关,但与以后的时间点无关。脐血胰岛素与出生体重和新生儿脂肪量呈正相关,与 2 年内的体重增加呈负相关,经多次调整后仍有显著相关性。随后按性别分层显示,与体重增加的这种关系更强,仅在女孩中具有显著性。

结论

脐血胰岛素与婴儿 2 年内的后续体重增加呈负相关,这种关系在女孩中更为明显。

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