Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.
MRC Integrated Epidemiology Unit at the University of Bristol, Rm OS11, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Diabetologia. 2018 Jan;61(1):242-252. doi: 10.1007/s00125-017-4457-2. Epub 2017 Oct 24.
AIMS/HYPOTHESIS: There is evidence that, from birth, South Asians are fatter, for a given body mass, than Europeans. The role of developmental overnutrition related to maternal adiposity and circulating glucose in these ethnic differences is unclear. Our aim was to compare associations of maternal gestational adiposity and glucose with adiposity at age 4/5 years in white British and Pakistani children.
Born in Bradford is a prospective study of children born between 2007 and 2010 in Bradford, UK. Mothers completed an OGTT at 27-28 weeks of gestation. We examined associations between maternal gestational BMI, fasting glucose, post-load glucose and diabetes (GDM) and offspring height, weight, BMI and subscapular skinfold (SSF) and triceps skinfold (TSF) thickness at age 4/5 years, using data from 6060 mother-offspring pairs (2717 [44.8%] white British and 3343 [55.2%] Pakistani).
Pakistani mothers had lower BMI and higher fasting and post-load glucose and were twice as likely to have GDM (defined using modified WHO criteria) than white British women (15.8% vs 6.9%). Pakistani children were taller and had lower BMI than white British children; they had similar SSF and lower TSF. Maternal BMI was positively associated with the adiposity of offspring in both ethnic groups, with some evidence of stronger associations in Pakistani mother-offspring pairs. For example, the difference in adjusted mean BMI per 1 kg/m greater maternal BMI was 0.07 kg/m (95% CI 0.05, 0.08) and 0.10 kg/m (95% CI 0.09. 0.11) in white British and Pakistani children, respectively, with equivalent results for SSF being 0.07 mm (95% CI 0.05, 0.08) and 0.09 mm (95% CI 0.08. 0.11) (p for ethnic difference < 0.03 for both). There was no strong evidence of association of fasting and post-load glucose, or GDM, with outcomes in either group.
CONCLUSIONS/INTERPRETATION: At age 4/5 years, Pakistani children are taller and lighter than white British children. While maternal BMI is positively associated with offspring adiposity, gestational glycaemia is not clearly related to offspring adiposity in either ethnic group.
目的/假设：有证据表明，从出生起，南亚人的体脂就比欧洲人高，体脂量相同的情况下也是如此。母亲肥胖和循环葡萄糖在这些种族差异中的发育性营养过剩的作用尚不清楚。我们的目的是比较白种英国人和巴基斯坦儿童的母亲妊娠期肥胖和葡萄糖与 4/5 岁时肥胖的相关性。
“出生于布拉德福德”是一项对英国布拉德福德 2007 年至 2010 年间出生的儿童进行的前瞻性研究。母亲在 27-28 周妊娠时完成口服葡萄糖耐量试验。我们使用 6060 对母婴数据（白种英国人 2717 例[44.8%]，巴基斯坦人 3343 例[55.2%]），分析了母亲妊娠期 BMI、空腹血糖、负荷后血糖和糖尿病（GDM）与子女 4/5 岁时身高、体重、BMI 以及肩胛下皮褶厚度（SSF）和肱三头肌皮褶厚度（TSF）厚度之间的关系。
巴基斯坦母亲的 BMI 较低，空腹和负荷后血糖较高，GDM 的发生率是白种英国妇女的两倍（15.8%对 6.9%）。巴基斯坦儿童比白种英国儿童更高，BMI 更低；他们的 SSF 相似，而 TSF 更低。在两个种族群体中，母亲 BMI 与后代的肥胖程度呈正相关，在巴基斯坦母婴对中，这种关联似乎更强。例如，在白种英国和巴基斯坦儿童中，母亲 BMI 每增加 1kg/m，调整后的平均 BMI 差异分别为 0.07kg/m（95%CI 0.05，0.08）和 0.10kg/m（95%CI 0.09，0.11），SSF 的等效结果为 0.07mm（95%CI 0.05，0.08）和 0.09mm（95%CI 0.08，0.11）（两组的种族差异 P<0.03）。空腹和负荷后血糖或 GDM 与两组的结果均无明显关联。
结论/解释：在 4/5 岁时，巴基斯坦儿童比白种英国儿童更高更轻。虽然母亲 BMI 与后代肥胖呈正相关，但在两个种族群体中，妊娠期血糖与后代肥胖均无明显关联。
