Zhao Y L, Ma R M, Lao T T, Chen Z, Du M Y, Liang K, Huang Y K, Zhang L, Yang M H, Sun Y H, Li H, Ding Z B
1Department of Obstetrics and Gynecology,First Affiliated Hospital of Kunming Medical University,Kunming,P.R. China.
2Department of Obstetrics and Gynecology,Chinese University of Hong Kong,Hong Kong Special Administrative Region,Hong Kong,P.R. China.
J Dev Orig Health Dis. 2015 Dec;6(6):479-84. doi: 10.1017/S2040174415007205.
The purpose of this study was to investigate the effects of maternal gestational diabetes mellitus (GDM) and breast feeding on childhood overweight and obesity in a mainland Chinese population. The incidence of and factors associated with overweight and obesity were compared between children of mothers with (n=1068) and without (n=1756) GDM. The independent roles of the associated factors were examined by multiple logistic regression analysis. The incidence of overweight was higher (16.6 v. 12.6%, P=0.002) in the GDM group, but that of obesity was not different (10.7 v. 12.0%, P=0.315). At age 1-2 and 2-5 years, no difference in overweight (11.0 v. 12.0%, P=0.917, and 15.7 v. 14.6%, P=0.693, respectively) was found, while obesity (8.0 v. 13.6%, P=0.019, and 8.4 v. 13.4%, P=0.014, respectively) was less frequent in the GDM offspring. At age 5-10 years, increased overweight (22.2 v. 12.1%, P<0.001) and obesity (15.9 v. 9.0%, P=0.001) were found in the GDM group, which was associated with maternal obesity, being born large-for-gestational age, male gender and formula feeding. After adjusting for confounding factors, GDM remained an independent determinant of offspring overweight and obesity (aOR 2.28, 95% CI 1.61-3.22), suggesting that the effects of GDM were independent of breast feeding, as well as of maternal obesity and birth size.
本研究旨在探讨中国大陆人群中母亲妊娠期糖尿病(GDM)及母乳喂养对儿童超重和肥胖的影响。比较了患有GDM(n = 1068)和未患GDM(n = 1756)的母亲所生子女超重和肥胖的发生率及相关因素。通过多因素逻辑回归分析检验相关因素的独立作用。GDM组超重发生率较高(16.6%对12.6%,P = 0.002),但肥胖发生率无差异(10.7%对12.0%,P = 0.315)。在1 - 2岁和2 - 5岁时,超重情况无差异(分别为11.0%对12.0%,P = 0.917;15.7%对14.6%,P = 0.693),而GDM母亲的后代肥胖发生率较低(分别为8.0%对13.6%,P = 0.019;8.4%对13.4%,P = 0.014)。在5 - 10岁时,GDM组超重(22.2%对12.1%,P < 0.001)和肥胖(15.9%对9.0%,P = 0.001)发生率增加,这与母亲肥胖、大于胎龄儿出生、男性性别及配方奶喂养有关。校正混杂因素后,GDM仍是后代超重和肥胖的独立决定因素(调整后比值比2.28,95%置信区间1.61 - 3.22),这表明GDM的影响独立于母乳喂养、母亲肥胖及出生体重。