Fried Ruby L, Mayol Nanette L, McDade Thom W, Kuzawa Christopher W
Department of Anthropology, Northwestern University, Evanston, Illinois, 60208.
USC - Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City, 6000, Philippines.
Am J Hum Biol. 2017 Sep 10;29(5). doi: 10.1002/ajhb.23011. Epub 2017 Apr 21.
Evidence that fetal development has long-term impacts on health has increased interest in maternal-fetal nutrient exchange. Although maternal metabolism is known to change during gestation to accommodate fetal nutrient demands, little is known about these modifications outside of a Western, clinical context. This study characterizes maternal metabolic adaptations to pregnancy, and their associations with offspring birth weight (BW), among women living in the Philippines.
Fasting glucose, triglycerides, insulin, leptin, and adiponectin were assessed in 808 participants in the Cebu Longitudinal Health and Nutrition Survey (Metropolitan Cebu, Philippines). Cross-sectional relationships between metabolites and hormones and gestational and lactational status were evaluated. Among the subset of currently pregnant women, associations between maternal glucose and triglycerides and offspring BW were also examined.
Women in their second and third trimesters had significantly lower fasting glucose and adiponectin compared to nulliparous women, and leptin levels and triglyceride levels were notably higher late in pregnancy (all P < .05). Among pregnant women, fasting glucose was a positive predictor of offspring BW, but only in males (P = .012, R = .28). Hormones and metabolites in post-partum women trend back toward levels found in nulliparous women, with some differences by breastfeeding status.
We find evidence for marked changes in maternal lipid and carbohydrate metabolism during pregnancy, consistent with known adaptations to support fetal growth. The finding of sex-specific relationships between maternal glucose and offspring BW adds to evidence for greater impacts of the maternal-gestational environment on biology and health in male offspring.
胎儿发育对健康有长期影响的证据增加了人们对母胎营养交换的兴趣。虽然已知孕期母亲代谢会发生变化以满足胎儿的营养需求，但在西方临床背景之外，对这些变化知之甚少。本研究描述了菲律宾女性孕期母亲的代谢适应性及其与后代出生体重（BW）的关系。
在宿务纵向健康与营养调查（菲律宾宿务市）的808名参与者中评估空腹血糖、甘油三酯、胰岛素、瘦素和脂联素。评估代谢物和激素与妊娠和哺乳状态之间的横断面关系。在当前孕妇亚组中，还研究了母亲血糖和甘油三酯与后代BW之间的关联。
与未生育女性相比，孕中期和孕晚期女性的空腹血糖和脂联素显著降低，妊娠后期瘦素水平和甘油三酯水平显著升高（均P < 0.05）。在孕妇中，空腹血糖是后代BW的正向预测因子，但仅在男性中如此（P = 0.012，R = 0.28）。产后女性的激素和代谢物水平趋向于恢复到未生育女性的水平，母乳喂养状态存在一些差异。
我们发现孕期母亲脂质和碳水化合物代谢有显著变化的证据，这与已知的支持胎儿生长的适应性变化一致。母亲血糖与后代BW之间存在性别特异性关系的发现进一步证明了母胎环境对男性后代生物学和健康的更大影响。
