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孕期母体脂肪摄入与后代代谢健康 - 一项具有 20 年随访的前瞻性研究。

Maternal intake of fat in pregnancy and offspring metabolic health - A prospective study with 20 years of follow-up.

机构信息

Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark.

Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, Building 1260, 8000 Aarhus, Denmark.

出版信息

Clin Nutr. 2016 Apr;35(2):475-483. doi: 10.1016/j.clnu.2015.03.018. Epub 2015 Apr 9.

Abstract

BACKGROUND

Maternal fat intake during pregnancy in relation to offspring metabolic outcomes has been studied primarily in animal models, yet little is known about the association in humans. The aim of this study was to examine the association of total and subtype of fat consumption in pregnancy with anthropometric measures and biomarkers of adiposity and glucose metabolism in the offspring.

METHODS

A source population was 965 Danish pregnant women recruited in 1988-1989 with offspring follow-up at 20 years. Information on fat intake was collected in the 30(th) week of gestation, and we subdivided fat according to saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fat. Offspring body mass index (BMI) and waist circumference (WC) were recorded at follow-up (n = 670-678), and biomarkers were quantified in a subset (n = 443) of participants. Multivariable linear and log-binomial regression were used to calculate effect estimates and 95% CI for a 1:1%energy substitution of carbohydrates for fat.

RESULTS

The mean (standard deviation) BMI was 22.1 (3.3) and 22.8 (2.9) kg/m(2) in female and male offspring, respectively. The median (10th to 90th percentile) of maternal fat intake was 31% of energy [23,39]. We found no overall associations for maternal fat intake with female offspring anthropometry. However, for male offspring higher intake of MUFA during pregnancy was associated with higher insulin levels at 20 years (Q4 vs. Q1: %Δ: 37, 95% CI: 1, 86) accompanied by a non-significant 3.6 (95% CI: -1.1, 8.2) cm increase in WC. High maternal total fat intake (>=35% energy) was also associated with higher BMI (0.9, 95% CI: 0.2, 1.6) and WC (4.0, 95% CI: 1.6, 2.3) among male offspring.

CONCLUSIONS

A high fat diet during pregnancy may increase adiposity in adult male offspring. We surmise that maternal MUFA intake during this time included both MUFA and trans fat misclassified as MUFA, and that the associations observed may be more reflective of the latter exposure.

摘要

背景

母体在怀孕期间的脂肪摄入量与后代的代谢结果有关,这主要在动物模型中进行了研究,但对于人类的相关性知之甚少。本研究旨在检查怀孕期间总脂肪和不同类型脂肪的摄入与后代人体测量指标以及肥胖和葡萄糖代谢生物标志物之间的关系。

方法

来源人群为 1988-1989 年招募的 965 名丹麦孕妇,其后代在 20 岁时进行随访。在妊娠 30 周时收集脂肪摄入量信息,我们根据饱和脂肪(SFA)、单不饱和脂肪(MUFA)和多不饱和脂肪(PUFA)对脂肪进行细分。在随访时(n=670-678)记录了后代的体重指数(BMI)和腰围(WC),并在一部分参与者(n=443)中定量了生物标志物。使用多变量线性和对数二项式回归计算了碳水化合物与脂肪能量替代率为 1:1%时的效应估计值和 95%置信区间。

结果

女性和男性后代的平均(标准差)BMI 分别为 22.1(3.3)和 22.8(2.9)kg/m2。母体脂肪摄入量的中位数(第 10 到第 90 个百分位数)为能量的 31%[23,39]。我们没有发现母体脂肪摄入与女性后代人体测量指标之间的总体关联。然而,对于男性后代,妊娠期间 MUFA 摄入较高与 20 岁时胰岛素水平升高有关(Q4 与 Q1 相比:%Δ:37,95%CI:1,86),同时 WC 增加了非显著的 3.6(95%CI:-1.1,8.2)cm。母体总脂肪摄入量(>=35%能量)也与男性后代较高的 BMI(0.9,95%CI:0.2,1.6)和 WC(4.0,95%CI:1.6,2.3)有关。

结论

怀孕期间高脂肪饮食可能会增加成年男性后代的肥胖程度。我们推测,此时母体 MUFA 的摄入既包括 MUFA,也包括被错误归类为 MUFA 的反式脂肪,观察到的关联可能更能反映后者的暴露情况。

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