First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece.
Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
J Pediatr. 2019 Jul;210:69-80.e5. doi: 10.1016/j.jpeds.2019.02.041. Epub 2019 Apr 13.
To determine if preterm birth is associated with components of the metabolic syndrome in adult life.
A structured literature search was performed using PubMed. All comparative studies reported metabolic and cardiovascular outcomes in adults (≥18 years of age) born preterm (<37 weeks of gestation) compared with adults born at term (37-42 weeks of gestation) and published through March 2018 were included. The major outcomes assessed were body mass index, waist circumference, waist-to-hip ratio, fat mass, systolic blood pressure (SBP), diastolic blood pressure (DBP), 24-hour SBP, 24-hour DBP, endothelium-dependent brachial artery flow-mediated dilation, carotid intima-media thickness, pulse wave velocity, fasting glucose and insulin, Homeostasis Model Assessment-Estimated Insulin Resistance Index, and lipid profiles. Quality appraisal was performed using a modified version of the Newcastle-Ottawa scale. A meta-analysis was performed for comparable studies which reported sufficient data.
Forty-three studies were included, including a combined total of 18 295 preterm and 294 063 term-born adults. Prematurity was associated with significantly higher fat mass (P = .03), SBP (P < .0001), DBP (P < .0001), 24-hour SBP (P < .001), and 24-hour DBP (P < .001). Furthermore, preterm-born adults presented higher values of fasting glucose (P = .01), insulin (P = .002), Homeostasis Model Assessment-Estimated Insulin Resistance Index (P = .05), and total cholesterol levels (P = .05) in comparison with adults born at term, in random effect models. No statistically significant difference was found between preterm and term-born adults for the other outcomes studied.
Preterm birth is strongly associated with a number of components of the metabolic syndrome and cardiovascular disease in adult life.
确定早产是否与成人生活中代谢综合征的组成部分有关。
使用 PubMed 进行了结构化文献检索。所有比较研究均报告了代谢和心血管结局，这些研究的对象是早产儿（<37 周妊娠）和足月儿（37-42 周妊娠），并于 2018 年 3 月前发表，这些研究的对象是成人（≥18 岁）。评估的主要结果是体重指数、腰围、腰臀比、体脂量、收缩压（SBP）、舒张压（DBP）、24 小时 SBP、24 小时 DBP、内皮依赖性肱动脉血流介导的扩张、颈动脉内膜中层厚度、脉搏波速度、空腹血糖和胰岛素、稳态模型评估估计的胰岛素抵抗指数以及血脂谱。使用纽卡斯尔-渥太华量表的改良版本进行质量评估。对于报告了足够数据的可比研究，进行了荟萃分析。
共纳入 43 项研究，包括早产儿和足月儿各 18295 例和 294063 例。早产与体脂量（P=0.03）、SBP（P<0.0001）、DBP（P<0.0001）、24 小时 SBP（P<0.001）和 24 小时 DBP（P<0.001）显著升高有关。此外，在随机效应模型中，与足月出生的成年人相比，早产儿的空腹血糖（P=0.01）、胰岛素（P=0.002）、稳态模型评估估计的胰岛素抵抗指数（P=0.05）和总胆固醇水平（P=0.05）值更高。对于其他研究的结果，早产儿和足月儿之间没有统计学上的显著差异。
早产与成人生活中代谢综合征和心血管疾病的多个组成部分密切相关。
