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极低出生体重(<1500克)的年轻成年人的最终身高和心脏代谢结局

Final height and cardiometabolic outcomes in young adults with very low birth weight (<1500 g).

作者信息

Sato Ryosuke, Maekawa Masato, Genma Rieko, Shirai Kenji, Ohki Shigeru, Morita Hiroshi, Suda Takafumi, Watanabe Hiroshi

机构信息

Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan; Department of Endocrinology and Metabolism, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.

Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.

出版信息

PLoS One. 2014 Nov 14;9(11):e112286. doi: 10.1371/journal.pone.0112286. eCollection 2014.

Abstract

OBJECTIVE

Individuals with very low birth weight (VLBW; <1500 g) are known to be predisposed to both short final height and cardiometabolic disorders. However, associations between final height and cardiometabolic outcomes including glucose metabolism in VLBW individuals in young adulthood are not fully investigated.

METHODS

We investigated glucose metabolism and other cardiometabolic outcomes such as lipid profiles, blood pressure, renal function, urinary albumin, and thyroid function in young adults with VLBW born between 1980 and 1990. Short stature was defined as a final height <10th percentile. Glucose intolerance [diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG)] was determined using 75-g oral glucose tolerance tests. Associations between final height and cardiometabolic outcomes were examined using logistic or multiple linear regression.

RESULTS

A total of 628 VLBW individuals were screened and 111 young adults with VLBW (19-30 years) participated in the study. Of the participants, 40 subjects (36%) had short stature with a final height <10th percentile. Eight subjects (7.2%) had glucose intolerance (1, diabetes; 6, IGT; 1, IFG). Short stature was correlated with glucose intolerance (odds ratio 11.1; 95% CI 1.92, 99.7; P = 0.006). Final height was inversely associated with the homeostatic model assessment (HOMA) of insulin resistance, HOMA-β, insulinogenic index, and total/LDL-cholesterol. The associations of final height with insulin sensitivity and lipid profiles remained after adjustment for target height and age at puberty onset.

CONCLUSIONS

Shorter final height was associated with less favorable metabolic profiles in young adults with VLBW, and may be partly mediated by reduced insulin sensitivity. These associations were independent of target height or age at puberty onset.

摘要

目的

出生体重极低(VLBW;<1500克)的个体易患成年终身高矮小和心脏代谢紊乱。然而,成年早期VLBW个体的终身高与包括葡萄糖代谢在内的心脏代谢结局之间的关联尚未得到充分研究。

方法

我们调查了1980年至1990年出生的成年早期VLBW个体的葡萄糖代谢及其他心脏代谢结局,如血脂谱、血压、肾功能、尿白蛋白和甲状腺功能。身材矮小定义为终身高低于第10百分位数。使用75克口服葡萄糖耐量试验确定葡萄糖不耐受[糖尿病、糖耐量受损(IGT)和空腹血糖受损(IFG)]。使用逻辑回归或多元线性回归检验终身高与心脏代谢结局之间的关联。

结果

共筛查了628名VLBW个体,111名成年早期VLBW个体(19 - 30岁)参与了研究。在参与者中,40名受试者(36%)身材矮小,终身高低于第10百分位数。8名受试者(7.2%)有葡萄糖不耐受(1例糖尿病;6例IGT;1例IFG)。身材矮小与葡萄糖不耐受相关(比值比11.1;95%可信区间1.92, 99.7;P = 0.006)。终身高与胰岛素抵抗的稳态模型评估(HOMA)、HOMA-β、胰岛素生成指数以及总胆固醇/低密度脂蛋白胆固醇呈负相关。在调整目标身高和青春期开始年龄后,终身高与胰岛素敏感性和血脂谱的关联仍然存在。

结论

在成年早期VLBW个体中,终身高较短与代谢状况较差相关,且可能部分由胰岛素敏感性降低介导。这些关联独立于目标身高或青春期开始年龄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b7e/4232389/9bdfacacf30f/pone.0112286.g001.jpg

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