Kaar J L, Brinton J T, Crume T, Hamman R F, Glueck D H, Dabelea D
1 Department of Pediatrics, Colorado School of Medicine, University of Colorado, Aurora, CO, USA.
2 Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
J Dev Orig Health Dis. 2014 Jun;5(3):214-8. doi: 10.1017/S204017441400021X.
To examine the association of cord blood leptin with body mass index (BMI) growth velocity from birth to 12 months of age among infants exposed and not exposed to over-nutrition in utero (defined as maternal overweight/obesity or presence of gestational diabetes).
185 infants enrolled in the Exploring Perinatal Outcomes among Children study (76 exposed and 109 not exposed) had leptin and insulin measured in cord blood. Longitudinal weight and length measures in the first 12 months of life (average 4 per participant) obtained from medical records were used to compute BMI growth rates. Mixed models were used to examine associations of cord blood leptin with growth.
Compared with unexposed infants, those exposed had significantly higher cord blood insulin (8.64 v. 6.97 uU/ml, P<0.01) and leptin levels (8.89 v. 5.92 ng/ml, P=0.05) as well as increased birth weights (3438.04 v. 3306.89 g, P=0.04). There was an inverse relationship between cord leptin levels and BMI growth from birth to 12 months of age (P=0.005); however, exposure to over-nutrition in utero did not significantly modify this association (P=0.59).
We provide support of a possible operational feedback mechanism by which lower cord blood leptin levels are associated with faster infant growth in the first year of life. Our data do not tend to support the hypothesis that this mechanism is altered in infants exposed to over-nutrition in utero; however our sample is too small to provide sufficient evidence. Larger epidemiological studies are needed to elucidate the mechanisms responsible for increased propensity for obesity in exposed offspring.
研究宫内暴露于（定义为母亲超重/肥胖或患有妊娠期糖尿病）和未暴露于过度营养的婴儿，其脐血瘦素与出生至12个月龄体重指数（BMI）增长速度之间的关联。
185名参与儿童围产期结局探索研究的婴儿（76名暴露组和109名非暴露组），检测其脐血中的瘦素和胰岛素水平。从医疗记录中获取婴儿出生后头12个月的纵向体重和身长测量值（每位参与者平均4次），用于计算BMI增长率。采用混合模型研究脐血瘦素与生长的关联。
与未暴露婴儿相比，暴露组婴儿的脐血胰岛素水平（8.64对6.97微单位/毫升，P<0.01）和瘦素水平（8.89对5.92纳克/毫升，P=0.05）显著更高，出生体重也更高（3438.04对3306.89克，P=0.04）。从出生到12个月龄，脐血瘦素水平与BMI增长呈负相关（P=0.005）；然而，宫内暴露于过度营养并未显著改变这种关联（P=0.59）。
我们支持一种可能的操作反馈机制，即较低的脐血瘦素水平与婴儿出生后第一年更快的生长相关。我们的数据不支持这样的假设，即这种机制在宫内暴露于过度营养的婴儿中会改变；然而我们的样本量太小，无法提供充分证据。需要更大规模的流行病学研究来阐明导致暴露后代肥胖倾向增加的机制。
