母亲孕前 BMI、后代出生后早期生长情况及其 5-6 岁时的代谢特征：ABCD 研究。

Maternal prepregnancy BMI, offspring's early postnatal growth, and metabolic profile at age 5-6 years: the ABCD Study.

机构信息

Departments of Public Health (A.J.J.M.O., K.S., T.G.M.V.), Clinical Epidemiology, Biostatistics, and Bioinformatics (T.J.R.), and Gynecology and Obstetrics (T.J.R., J.A.M.v.d.P.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; and Department of Epidemiology and Health Promotion (M.v.E.), Public Health Service, 1018 WT Amsterdam, The Netherlands.

出版信息

J Clin Endocrinol Metab. 2014 Oct;99(10):3845-54. doi: 10.1210/jc.2014-1561. Epub 2014 Jun 23.

DOI:10.1210/jc.2014-1561

PMID:24955609

Abstract

CONTEXT

Maternal prepregnancy body mass index (pBMI) and offspring's accelerated postnatal growth have adverse consequences for later cardiometabolic health, but it is unknown how these two factors interact.

OBJECTIVE

To assess the association between maternal pBMI and offspring's metabolic profile at age 5-6 years and determine the role (independent/mediating/moderating) of offspring's postnatal growth in this association.

DESIGN/PARTICIPANTS: In total, 1459 mother-child pairs from the prospective ABCD study with known maternal pBMI, offspring postnatal growth (weight and weight-for-length gain) between age 1-3 months (Δ SD score).

MAIN OUTCOME MEASURES

We analyzed metabolic components of offspring at age 5-6 years, including waist-to-height-ratio (WHtR), systolic/diastolic blood pressure (SBP/DBP), fasting glucose, triglycerides, and high-density lipoprotein-cholesterol values, both individually (Z-scores) and combined (sum Z-scores; metabolic score).

RESULTS

Maternal pBMI was positively associated with offspring's WHtR (β = 0.025; 95% confidence interval [CI], 0.010-0.039), SBP (β = 0.020; 95% CI, 0.005-0.0035), DBP (β = 0.016; 95% CI, 0.000-0.031), and metabolic score (β = 0.078; 95% CI, 0.039-0.118) after adjusting. Adding postnatal growth had no relevant impact on these effect sizes. Postnatal weight gain was independently associated with WHtR (β = 0.199; 95% CI, 0.097-0.300), fasting glucose values (β = 0.117; 95% CI, 0.008-0.227), metabolic score (β = 0.405; 95% CI, 0.128-0.682). Postnatal weight-for-length gain was independently associated with WHtR (β = 0.145; 95% CI, 0.080-0.211), and metabolic score (β = 0.301; 95% CI, 0.125-0.477). An interaction between maternal pBMI and postnatal weight gain was present in the association with SBP (P = .021) and metabolic score (P = .047), and between maternal pBMI and postnatal weight-for-length gain in the association with triglycerides (P = .022) and metabolic score (P = .042).

CONCLUSIONS

Both high maternal pBMI and postnatal accelerated growth are associated with adverse metabolic components in early childhood. No evidence was found for a mediating role of postnatal growth. The combination of high maternal pBMI and postnatal accelerated growth amplified individual effects.

摘要

背景

母体孕前体重指数（pBMI）和后代出生后快速生长都会对日后心血管代谢健康产生不良影响，但目前尚不清楚这两个因素是如何相互作用的。

目的

评估母体 pBMI 与后代 5-6 岁时代谢特征之间的关联，并确定后代出生后生长在这种关联中的作用（独立/中介/调节）。

设计/参与者：共有 1459 对母子参与前瞻性 ABCD 研究，已知母体 pBMI、后代 1-3 个月间的出生后生长（体重和体重-身长增长）（ΔSD 评分）。

主要结局测量

我们分析了后代 5-6 岁时的代谢成分，包括腰高比（WHtR）、收缩压/舒张压（SBP/DBP）、空腹血糖、甘油三酯和高密度脂蛋白胆固醇值，分别以 Z 分数（个体）和总和 Z 分数（代谢评分）表示。

结果

调整后，母体 pBMI 与后代的 WHtR（β=0.025；95%置信区间[CI]，0.010-0.039）、SBP（β=0.020；95%CI，0.005-0.0035）、DBP（β=0.016；95%CI，0.000-0.031）和代谢评分（β=0.078；95%CI，0.039-0.118）呈正相关。添加出生后生长对这些效应大小没有显著影响。出生后体重增长与 WHtR（β=0.199；95%CI，0.097-0.300）、空腹血糖值（β=0.117；95%CI，0.008-0.227）和代谢评分（β=0.405；95%CI，0.128-0.682）独立相关。出生后体重-身长增长与 WHtR（β=0.145；95%CI，0.080-0.211）和代谢评分（β=0.301；95%CI，0.125-0.477）独立相关。母体 pBMI 与出生后体重增长之间存在与 SBP（P=0.021）和代谢评分（P=0.047）相关的交互作用，与出生后体重-身长增长之间存在与甘油三酯（P=0.022）和代谢评分（P=0.042）相关的交互作用。