Department of Family Medicine and Public Health Sciences, Division of Population Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA.
Nutr Diabetes. 2013 Aug 26;3(8):e84. doi: 10.1038/nutd.2013.25.
Differences in body fat distribution contribute to the metabolic abnormalities associated with overweight and obesity; however, such differences have not been adequately explored during pregnancy. Our aim was to compare longitudinal trends in maternal abdominal adipose tissue deposition during pregnancy in overweight/obese compared with normal weight women.
Pregnant women, classified as normal weight (body mass index (BMI) <25 kg m(-2); N=61) or overweight/obese (BMI 25 kg m(-2); N=57), were enrolled in a prospective cohort study starting in the first trimester. Maternal subcutaneous (smin) and preperitoneal (pmax) fat were measured by ultrasound at five time points starting between 6 and 10 weeks gestation. The abdominal fat index (AFI), an established marker of visceral adipose tissue, was calculated as the ratio of pmax to smin. The trajectories of smin, pmax, cumulative fat index (smin plus pmax) and the AFI across pregnancy were analyzed using mixed linear models.
The rate of maternal weight gain during pregnancy was significantly lower for overweight/obese women compared with their non-overweight counterparts (P<0.05). Accordingly, the rate of change of pmax and smin differed significantly in normal weight compared with overweight/obese women (P=0.0003 and 0.01, respectively). The cumulative fat index did not change across gestation in normal weight women, whereas it decreased for overweight/obese women (P=0.0005). The log AFI increased across pregnancy in both strata, but significantly more rapidly for normal weight compared with overweight/obese women (P=0.06).
Adipose tissue is preferentially deposited in the more metabolically active visceral compartment as pregnancy progresses. However, this process differs in normal weight compared with overweight/obese women and may contribute to metabolic differences between these groups. Our study is a step toward a more refined description of obesity and its consequences during pregnancy.
体脂分布的差异导致了与超重和肥胖相关的代谢异常；然而，在怀孕期间，这些差异尚未得到充分的探索。我们的目的是比较超重/肥胖与正常体重孕妇在怀孕期间腹部脂肪组织沉积的纵向变化趋势。
本前瞻性队列研究招募了孕妇，根据体重指数（BMI）分为正常体重（BMI<25kg/m²；N=61）和超重/肥胖（BMI≥25kg/m²；N=57）两组，从妊娠早期第 6 周到第 10 周开始，每 5 周通过超声检查测量孕妇的皮下（smin）和腹膜前（pmax）脂肪。腹部脂肪指数（AFI）是内脏脂肪组织的一个既定标志物，通过 pmax 与 smin 的比值计算得出。使用混合线性模型分析整个孕期 smin、pmax、累积脂肪指数（smin+pmax）和 AFI 的变化轨迹。
与非超重孕妇相比，超重/肥胖孕妇在怀孕期间的体重增长速度明显较慢（P<0.05）。因此，正常体重孕妇的 pmax 和 smin 的变化率与超重/肥胖孕妇有显著差异（P=0.0003 和 0.01）。正常体重孕妇的累积脂肪指数在整个孕期没有变化，而超重/肥胖孕妇的累积脂肪指数则下降（P=0.0005）。AFI 在两个组中都随着孕期的进展而增加，但正常体重孕妇的增长速度明显快于超重/肥胖孕妇（P=0.06）。
随着孕期的进展，脂肪组织优先沉积在代谢更活跃的内脏部位。然而，这一过程在正常体重孕妇和超重/肥胖孕妇之间存在差异，可能导致这两组之间的代谢差异。我们的研究是对肥胖及其在怀孕期间的影响进行更精确描述的一个步骤。
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