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孕期前体重不同,母体瘦素与新生儿肥胖的关联也不同。

Associations of Maternal Leptin with Neonatal Adiposity Differ according to Pregravid Weight.

作者信息

Patenaude Julie, Lacerte Guillaume, Lacroix Marilyn, Guillemette Laetitia, Allard Catherine, Doyon Myriam, Battista Marie-Claude, Moreau Julie, Ménard Julie, Ardilouze Jean-Luc, Perron Patrice, Hivert Marie-France

机构信息

Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada.

出版信息

Neonatology. 2017;111(4):344-352. doi: 10.1159/000454756. Epub 2017 Jan 18.

Abstract

BACKGROUND

During pregnancy, maternal circulating leptin is released by maternal adipose tissue and the placenta, and may have a role in fetal development.

OBJECTIVES

We investigated maternal leptinemia and glycemia associations with neonatal adiposity, taking into account pregravid weight status.

METHODS

We included 235 pregnant women from the Genetics of Glucose Regulation in Gestation and Growth prospective cohort with data: blood samples collected during the 2nd trimester, an oral glucose tolerance test (OGTT), and the measured leptin and glucose levels. As an integrated measure of maternal leptin exposure, we calculated the area under the curve for maternal leptin at the OGTT (AUCleptin). Within 72 h of delivery, we measured the triceps, biceps, subscapular, and suprailiac skinfold thicknesses (SFTs); the sum of these SFTs represented neonatal adiposity. We conducted a regression analysis to assess the maternal metabolic determinants of neonatal adiposity, adjusting for parity, smoking status, maternal triglyceride levels, gestational weight gain, placental weight, delivery mode, neonate sex, and gestational age at delivery.

RESULTS

The pregravid BMI of the participating women was 23.3 (21.2-27.0). In the 2nd trimester, maternal AUCleptin was 1,292.0 (767.0-2,222.5) (ng × min)/mL, and fasting glucose levels were 4.2 ± 0.4 mmol/L. At delivery, the neonatal sum of 4 SFTs was 17.9 ± 3.3 mm. Higher maternal leptinemia was associated with higher neonatal adiposity (β = 4.23 mm [SE = 1.77] per log-AUCleptin; p = 0.02) in mothers with a BMI ≥25, independently of confounders and maternal glycemia, but not in mothers with a BMI <25. Higher maternal fasting glucose was associated with higher neonatal adiposity (β = 0.88 mm [SE = 0.30] per SD glucose; p = 0.005) in mothers with a BMI <25, independently of confounders and maternal leptinemia.

CONCLUSION

Maternal leptinemia may be associated with neonatal adiposity in offspring from overweight/obese mothers, independently of maternal glycemia.

摘要

背景

孕期,母体循环中的瘦素由母体脂肪组织和胎盘释放,可能在胎儿发育中起作用。

目的

我们研究了母体瘦素血症和血糖与新生儿肥胖的关联,并考虑了孕前体重状况。

方法

我们纳入了来自“妊娠与生长中葡萄糖调节的遗传学”前瞻性队列的235名孕妇的数据:孕中期采集的血样、口服葡萄糖耐量试验(OGTT)以及测得的瘦素和葡萄糖水平。作为母体瘦素暴露的综合指标,我们计算了OGTT时母体瘦素的曲线下面积(AUC瘦素)。在分娩后72小时内,我们测量了肱三头肌、肱二头肌、肩胛下和髂上皮肤褶皱厚度(SFT);这些SFT的总和代表新生儿肥胖程度。我们进行了回归分析,以评估新生儿肥胖的母体代谢决定因素,并对胎次、吸烟状况、母体甘油三酯水平、孕期体重增加、胎盘重量、分娩方式、新生儿性别和分娩时的孕周进行了校正。

结果

参与研究的女性孕前BMI为23.3(21.2~27.0)。孕中期,母体AUC瘦素为1292.0(767.0~2222.5)(纳克×分钟)/毫升,空腹血糖水平为4,2±0.4毫摩尔/升。分娩时,新生儿4项SFT总和为17.9±3.3毫米。在BMI≥25的母亲中,较高的母体瘦素血症与较高的新生儿肥胖相关(每对数AUC瘦素β=4.23毫米[标准误=1.77];p=0.02),独立于混杂因素和母体血糖,但在BMI<25的母亲中则不然。在BMI<25的母亲中,较高的母体空腹血糖与较高的新生儿肥胖相关(每标准差血糖β=0.88毫米[标准误=0.30];p=0.005),独立于混杂因素和母体瘦素血症。

结论

母体瘦素血症可能与超重/肥胖母亲后代的新生儿肥胖有关,独立于母体血糖。

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