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儿童 BMI 与成人 2 型糖尿病、冠状动脉疾病、慢性肾脏病和心脏代谢特征:孟德尔随机分析。

Childhood BMI and Adult Type 2 Diabetes, Coronary Artery Diseases, Chronic Kidney Disease, and Cardiometabolic Traits: A Mendelian Randomization Analysis.

机构信息

Epidemiology Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA.

出版信息

Diabetes Care. 2018 May;41(5):1089-1096. doi: 10.2337/dc17-2141. Epub 2018 Feb 26.

Abstract

OBJECTIVE

To test the causal effect of childhood BMI on adult cardiometabolic diseases using a Mendelian randomization analysis.

RESEARCH DESIGN AND METHODS

We used 15 single nucleotide polymorphisms as instrumental variables for childhood BMI to test the causal effect of childhood BMI on cardiometabolic diseases using summary-level data from consortia.

RESULTS

We found that a 1-SD increase in childhood BMI (kg/m) was associated with an 83% increase in risk of type 2 diabetes (odds ratio [OR] 1.83 [95% CI 1.46, 2.30]; = 2.5 × 10) and a 28% increase in risk of coronary artery disease (CAD) (OR 1.28 [95% CI 1.17, 1.39]; = 2.1 × 10) at the Bonferroni-adjusted level of significance ( < 0.017) in adults. In addition, a 1-SD increase in childhood BMI was associated with a 0.587-SD increase in adulthood BMI (kg/m), a 0.062-SD increase in hip circumference (cm), a 0.602-SD increase in waist circumference (cm), a 0.111 pmol/L increase in log fasting insulin, a 0.068 increase in log-transformed HOMA of ß-cell function (%), a 0.126 increase in log-transformed HOMA of insulin resistance (%), and a 0.109-SD increase in triglyceride (mg/dL) but a 0.138-SD decrease in HDL (mg/dL) in adults at the Bonferroni-adjusted level of significance ( < 0.0026).

CONCLUSIONS

A genetic predisposition to higher childhood BMI was associated with increased risk of type 2 diabetes and CAD in adult life. These results provide evidence supportive of a causal association between childhood BMI and these outcomes.

摘要

目的

利用孟德尔随机化分析检验儿童 BMI 对成年人心血管代谢疾病的因果效应。

研究设计和方法

我们使用 15 个单核苷酸多态性作为儿童 BMI 的工具变量,利用联盟的汇总水平数据,检验儿童 BMI 对心血管代谢疾病的因果效应。

结果

我们发现,儿童 BMI(kg/m)每增加 1 个标准差,患 2 型糖尿病的风险增加 83%(比值比[OR]1.83[95%可信区间 1.46, 2.30];=2.5×10),患冠心病(CAD)的风险增加 28%(OR 1.28[95%可信区间 1.17, 1.39];=2.1×10),这在Bonferroni 调整的显著性水平(<0.017)。此外,儿童 BMI 每增加 1 个标准差,成年人的 BMI(kg/m)增加 0.587 个标准差,臀围增加 0.062cm,腰围增加 0.602cm,空腹胰岛素的对数增加 0.111pmol/L,HOMA-β细胞功能(%)的对数增加 0.068,HOMA 胰岛素抵抗(%)的对数增加 0.126,甘油三酯(mg/dL)增加 0.109 个标准差,但高密度脂蛋白(HDL)(mg/dL)减少 0.138 个标准差。

结论

儿童 BMI 遗传倾向较高与成年后患 2 型糖尿病和 CAD 的风险增加相关。这些结果为儿童 BMI 与这些结果之间存在因果关系提供了证据。

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