Voerman Ellis, Jaddoe Vincent W V, Franco Oscar H, Steegers Eric A P, Gaillard Romy
The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Diabetologia. 2017 Jan;60(1):81-88. doi: 10.1007/s00125-016-4135-9. Epub 2016 Oct 18.
AIMS/HYPOTHESIS: We aimed to identify critical periods and specific longitudinal growth patterns from fetal life onwards associated with childhood insulin and C-peptide levels.
In a prospective population-based cohort study of 4328 children, we repeatedly measured (femur) length and (estimated fetal) weight from the second trimester of fetal life until 6 years of age. BMI was calculated from 6 months onwards. Insulin and C-peptide levels were measured at 6 years of age.
Preterm birth and small or large size for gestational age at birth were not associated with childhood insulin levels. Conditional growth modelling showed that, independent of growth in other time intervals, weight growth in each time interval from birth onwards, length growth from 6 months onwards and BMI growth from 12 months onwards were positively associated with childhood insulin levels. The strongest associations were present for weight and BMI growth between 48 and 72 months of age. Repeated measurement analyses showed that, compared with children in the lowest quartile of childhood insulin, those in the highest quartile had a higher length from birth onwards and a higher weight and BMI from 24 months onwards. These differences increased with age. No associations were observed for fetal growth characteristics. Similar results were observed for C-peptide levels.
CONCLUSIONS/INTERPRETATION: Our results suggest that rapid length, weight and BMI growth from birth onwards, but not during fetal life, is associated with higher insulin levels in childhood.
目的/假设：我们旨在确定从胎儿期开始直至儿童期与胰岛素和C肽水平相关的关键时期及特定纵向生长模式。
在一项基于人群的前瞻性队列研究中，我们对4328名儿童进行了研究，从胎儿期的孕中期直至6岁，反复测量（股骨）长度和（估计胎儿）体重。从6个月起计算体重指数（BMI）。在6岁时测量胰岛素和C肽水平。
早产以及出生时小于或大于胎龄均与儿童期胰岛素水平无关。条件生长模型显示，与其他时间段的生长无关，从出生起每个时间段的体重增长、6个月起的身长增长以及12个月起的BMI增长均与儿童期胰岛素水平呈正相关。48至72个月龄之间的体重和BMI增长呈现出最强的相关性。重复测量分析显示，与儿童期胰岛素水平处于最低四分位数的儿童相比，处于最高四分位数的儿童从出生起身长更高，从24个月起体重和BMI更高。这些差异随年龄增加。未观察到与胎儿生长特征有关联。C肽水平也观察到类似结果。
结论/解读：我们的结果表明，从出生起而非胎儿期的快速身长、体重和BMI增长与儿童期较高的胰岛素水平相关。
