Oken Emily, Morton-Eggleston Emma, Rifas-Shiman Sheryl L, Switkowski Karen M, Hivert Marie-France, Fleisch Abby F, Mantzoros Christos, Gillman Matthew W
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.
Am J Perinatol. 2016 Nov;33(13):1273-1281. doi: 10.1055/s-0036-1586509. Epub 2016 Aug 4.
Few studies have examined sex-specific associations of maternal gestational glycemia with cord blood hormones, which might predict later health. In 976 women without pre-existing diabetes in the Project Viva cohort, we used linear regression to examine associations of maternal gestational glycemia with cord hormone concentrations, adjusted for maternal characteristics and stratified by infant sex. A total of 6.1% of women had gestational diabetes mellitus (GDM), 8.8% isolated hyperglycemia, 3.2% gestational impaired glucose tolerance, and 81.9% were normoglycemic. In boys, compared with infants of normoglycemic mothers, infants of GDM mothers had higher cord levels of IGF-2 (β 35.55 ng/mL; 95% CI: 2.60, 68.50), IGFBP-3 (111.2 ng/mL; 5.53, 216.8), insulin (4.66 uU/mL; 2.38, 6.95), C-peptide (0.46 ng/mL; 0.25, 0.67), and leptin (3.51 ng/mL; 1.37, 5.64), but lower IGF-1 (-6.71 ng/mL; -12.7, - 0.76, adjusted for IGFBP-3). In girls, GDM offspring had higher cord blood levels of IGF-1 adjusted for IGFBP-3 (12.45 ng/mL; 4.85, 20.04). Boys, but not girls, of mothers with abnormal glucose tolerance but not GDM also had higher levels of some hormones. GDM was associated with growth factors and adipokines in cord blood from boys, but only IGF-1 in girls. These findings suggest sex differences in responses to fetal overnutrition.
很少有研究探讨孕期母亲血糖水平与脐带血激素之间的性别特异性关联，而这些激素可能预示着后代未来的健康状况。在“活力计划”队列中的976名无糖尿病病史的女性中，我们采用线性回归分析，在调整了母亲的特征因素后，按婴儿性别分层，研究孕期母亲血糖水平与脐带血激素浓度之间的关联。共有6.1%的女性患有妊娠期糖尿病（GDM），8.8%为单纯性高血糖，3.2%为妊娠期糖耐量受损，81.9%血糖正常。在男孩中，与血糖正常母亲的婴儿相比，GDM母亲的婴儿脐带血中IGF-2（β=35.55 ng/mL；95%置信区间：2.60，68.50）、IGFBP-3（111.2 ng/mL；5.53，216.8）、胰岛素（4.66 uU/mL；2.38，6.95）、C肽（0.46 ng/mL；0.25，0.67）和瘦素（3.51 ng/mL；1.37, 5.64）水平较高，但IGF-1水平较低（-6.71 ng/mL；-12.7，-0.76，校正IGFBP-3后）。在女孩中，校正IGFBP-3后，GDM母亲后代的脐带血IGF-1水平较高（12.45 ng/mL；4.85，20.04）。葡萄糖耐量异常但非GDM母亲的男孩（而非女孩）某些激素水平也较高。GDM与男孩脐带血中的生长因子和脂肪因子有关，而与女孩脐带血中仅IGF-1有关。这些发现表明，胎儿营养过剩的反应存在性别差异。
