Perng Wei, Gillman Matthew W, Mantzoros Christos S, Oken Emily
Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA.
Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA; Department of Nutrition, Harvard School of Public Health, Boston, MA.
Ann Epidemiol. 2014 Nov;24(11):793-800.e1. doi: 10.1016/j.annepidem.2014.08.002. Epub 2014 Sep 3.
To examine the relations of maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) with offspring cardiometabolic health.
We studied 1090 mother-child pairs in Project Viva, a Boston-area prebirth cohort. We measured overall (dual x-ray absorptiometry total fat; body mass index z-score) and central adiposity (dual x-ray absorptiometry trunk fat), and systolic blood pressure in offspring at 6 to 10 years. Fasting bloods (n = 687) were assayed for insulin and glucose (for calculation of homeostatic model assessment of insulin resistance), triglycerides, leptin, adiponectin, high sensitivity C-reactive protein, and interleukin 6. Using multivariable linear regression, we examined differences in offspring outcomes per 1 SD maternal ppBMI and GWG.
After adjustment for confounders, each 5 kg/m² higher ppBMI corresponded with 0.92 kg (95% confidence interval, 0.70-1.14) higher total fat, 0.27 BMI z-score (0.21-0.32), and 0.39 kg (0.29-0.49) trunk fat. ppBMI was also positively associated with homeostatic model assessment of insulin resistance, leptin, high sensitivity C-reactive protein, interleukin 6, and systolic blood pressure; and lower adiponectin. Each 5 kg of GWG predicted greater adiposity (0.33 kg [0.11-0.54] total fat; 0.14 kg [0.04-0.23] trunk fat) and higher leptin (6% [0%-13%]) in offspring after accounting for confounders and ppBMI.
Children born to heavier mothers have more overall and central fat and greater cardiometabolic risk. Offspring of women with higher GWG had greater adiposity and higher leptin.
研究孕妇孕前体重指数（ppBMI）和孕期体重增加（GWG）与子代心脏代谢健康之间的关系。
我们在波士顿地区的一个产前队列“活力计划”中研究了1090对母婴。我们测量了子代6至10岁时的总体脂肪（双能X线吸收法测量的总脂肪量；体重指数z评分）和中心性肥胖（双能X线吸收法测量的躯干脂肪）以及收缩压。对687例子代进行空腹血检，检测胰岛素、葡萄糖（用于计算胰岛素抵抗稳态模型评估值）、甘油三酯、瘦素、脂联素、高敏C反应蛋白和白细胞介素6。使用多变量线性回归，我们研究了母体ppBMI和GWG每增加1个标准差时子代结局的差异。
在对混杂因素进行校正后，ppBMI每升高5kg/m²，对应总脂肪量增加0.92kg（95%置信区间为0.70-1.14）、体重指数z评分增加0.27（0.21-0.32）、躯干脂肪增加0.39kg（0.29-0.49）。ppBMI还与胰岛素抵抗稳态模型评估值、瘦素、高敏C反应蛋白、白细胞介素6和收缩压呈正相关，与脂联素呈负相关。在考虑混杂因素和ppBMI后，GWG每增加5kg可预测子代肥胖增加（总脂肪量增加0.33kg[0.11-0.54]；躯干脂肪增加0.14kg[0.04-0.23]）以及瘦素升高（6%[0%-13%]）。
母亲体重较重的孩子总体脂肪和中心性脂肪更多，心脏代谢风险更大。孕期体重增加较多的女性所生的子代肥胖程度更高，瘦素水平更高。
