Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Diabet Med. 2018 Oct;35(10):1399-1403. doi: 10.1111/dme.13765. Epub 2018 Aug 2.
Metabolic dysregulation in utero may influence fetal metabolism and early growth. We previously investigated relationships between maternal indices of glucose homeostasis and triglycerides as well as cord blood insulin with offspring anthropometry up to 2 years. The aim of this analysis was to follow these relationships up to the age of 5 years.
Associations between maternal metabolic variables of glucose and lipid metabolism measured at 32 weeks' gestation and cord blood insulin with growth and body composition of 162 offspring aged 3-5 years were explored. Both indirect (i.e. body weight, BMI percentiles, sum of four skinfold thicknesses) and direct (i.e. ultrasonography, magnetic resonance imaging in a subgroup) measurement techniques were employed.
Maternal metabolic indices were largely unrelated to child body composition. Cord blood insulin was negatively associated with fat mass and lean body mass at 3 years in unadjusted analyses, and the sum of four skinfold thicknesses and body fat percentage in adjusted analyses, whereas the association with lean body mass was no longer observed. An inverse relationship between cord blood insulin and weight gain up to 5 years was observed in girls only with small effect sizes.
Results from this follow-up do not provide convincing evidence that these markers are independently related to offspring growth and adiposity in early childhood. Although cord blood insulin was weakly inversely related to weight gain in girls at 5 years, we cannot conclude that the observed changes in outcomes are clinically meaningful. (Clinical Trials Registry No: NCT00362089).
子宫内代谢失调可能会影响胎儿的代谢和早期生长。我们之前研究了母体葡萄糖稳态和甘油三酯以及脐血胰岛素与后代 2 岁以下人体测量学之间的关系。本分析的目的是将这些关系追踪到 5 岁。
探讨了妊娠 32 周时母体葡萄糖和脂质代谢的代谢变量以及脐血胰岛素与 162 名 3-5 岁儿童生长和身体成分的关系。采用间接(即体重、BMI 百分位数、四个皮褶厚度之和)和直接(即超声检查、磁共振成像在亚组)测量技术。
母体代谢指标与儿童身体成分基本无关。在未调整的分析中,脐血胰岛素与 3 岁时的脂肪量和瘦体量呈负相关,与调整后的分析中四个皮褶厚度之和和体脂肪百分比呈负相关,而与瘦体量的相关性则不再存在。仅在女孩中观察到脐血胰岛素与 5 岁时体重增加呈负相关,且效应大小较小。
本随访研究结果并未提供令人信服的证据表明这些标志物与儿童早期生长和肥胖有关。尽管在女孩中,5 岁时脐血胰岛素与体重增加呈弱负相关,但我们不能得出观察到的结果变化具有临床意义的结论。(临床试验注册号:NCT00362089)。