Brandt Stephanie, Moß Anja, Lennerz Belinda, Koenig Wolfgang, Weyermann Maria, Rothenbacher Dietrich, Brenner Hermann, Wabitsch Martin
Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetes, University Medical Center Ulm, 89075, Ulm, Germany.
Pediatr Diabetes. 2014 Sep;15(6):453-63. doi: 10.1111/pedi.12109. Epub 2014 Jan 17.
The cardiovascular risk factor profile of a child as well as the development of body weight are influenced by genetic and childhood factors. Circulating insulin concentrations reflect the metabolic cardiovascular risk and may trigger weight gain. We aimed at identifying parental and childhood factors which may influence fasting plasma insulin concentrations in children.
The Ulm Birth Cohort study (UBCS) is a prospective birth cohort study. At baseline, birth characteristics, maternal pre-pregnancy body mass index (BMI) values as well as parental socioeconomic parameters were obtained. At the 8-yr follow-up examination, weights, heights, and fasting plasma insulin concentrations in n = 422 children and their parents were measured. Offspring of women with gestational diabetes mellitus were excluded from statistical analysis.
Fasting plasma insulin concentrations of children were significantly correlated with maternal pre-pregnancy BMI values (r = 0.16) as well as with maternal (r = 0.26) but not with paternal fasting plasma insulin concentrations (r = 0.11) at the 8-yr follow-up examination. The risk for high fasting plasma insulin concentrations (≥75th internal percentile) was 2.30 (1.34-3.92) in children who also had high plasma insulin concentrations in umbilical cord blood compared to children having lower plasma insulin concentrations (<75th internal percentile) in umbilical cord blood. In addition, we observed that children with high fasting plasma insulin concentrations at the age of 8 had an altered BMI trajectory in childhood, characterized by higher BMI values from the age of 1 onwards, compared to children with lower insulin concentrations.
Our observations support the hypothesis of perinatal programming of offspring insulin concentrations and BMI values by maternal pre-pregnancy BMI values.
儿童的心血管危险因素状况以及体重发展受到遗传和童年因素的影响。循环胰岛素浓度反映代谢性心血管风险，并可能引发体重增加。我们旨在确定可能影响儿童空腹血浆胰岛素浓度的父母和童年因素。
乌尔姆出生队列研究（UBCS）是一项前瞻性出生队列研究。在基线时，获取出生特征、母亲孕前体重指数（BMI）值以及父母的社会经济参数。在8年随访检查中，测量了422名儿童及其父母的体重、身高和空腹血浆胰岛素浓度。患有妊娠期糖尿病的女性的后代被排除在统计分析之外。
在8年随访检查中，儿童的空腹血浆胰岛素浓度与母亲孕前BMI值（r = 0.16）以及母亲的空腹血浆胰岛素浓度（r = 0.26）显著相关，但与父亲的空腹血浆胰岛素浓度（r = 0.11）无关。与脐带血中血浆胰岛素浓度较低（<第75百分位数）的儿童相比，脐带血中血浆胰岛素浓度也较高的儿童发生高空腹血浆胰岛素浓度（≥第75百分位数）的风险为2.30（1.34 - 3.92）。此外，我们观察到，8岁时高空腹血浆胰岛素浓度的儿童在童年期的BMI轨迹有所改变，其特征是从1岁起BMI值较高，而胰岛素浓度较低的儿童则不然。
我们的观察结果支持母亲孕前BMI值对后代胰岛素浓度和BMI值进行围产期编程的假说。
