Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Chinese People's Liberation Army General Hospital, Beijing, China.
J Diabetes. 2020 Jan;12(1):10-20. doi: 10.1111/1753-0407.12960. Epub 2019 Jul 9.
This study investigated the association between birth weight and diabetes in a Chinese population, and the effects of body mass index (BMI) and lifestyle factors in later life on this association.
Data from 49 118 participants aged ≥40 years with recalled birth weight from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, a nationwide population-based cohort, were used. Diabetes diagnosis was based on oral glucose tolerance tests and HbA1c measurements. Logistic regression models were used to evaluate the association of birth weight and risk of diabetes in later life.
Increased risk of diabetes was associated with lower or higher birth weight. Compared with individuals with a birth weight of 2500 to 3499 g, the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes for individuals with a birth weight of <2500, between 3500 and 3999, and ≥4000 g were 1.28 (1.11-1.47), 1.11 (1.04-1.19), and 1.20 (1.07-1.34), respectively. Significant associations were prominent in participants with a current BMI ≥24 kg/m , but not detected in those with a normal BMI (OR 1.20 [95% CI 0.96-1.49], 1.11 [95% CI 0.98-1.25], and 1.10 [95% CI 0.89-1.37], respectively). Moreover, there was no increased risk of diabetes in individuals with a low birth weight but with healthy dietary habits (OR 0.94; 95% CI 0.68-1.29) or ideal physical activity (OR 1.41; 95% CI 0.97-2.04).
A U-shaped association was observed between birth weight and the risk of diabetes. Healthy lifestyles (healthy dietary habits or ideal physical activity) may eliminate the negative effects of low birth weight in the development of diabetes, but not the effect of high birth weight.
本研究在中国人群中调查了出生体重与糖尿病之间的关系，并探讨了生命后期体重指数（BMI）和生活方式因素对这种关系的影响。
本研究使用了来自全国性基于人群的队列研究——中国糖尿病风险评估：一项纵向（REACTION）研究的数据，该研究纳入了 49118 名年龄≥40 岁、 recalled birth weight 的参与者。糖尿病的诊断基于口服葡萄糖耐量试验和糖化血红蛋白测量。采用 logistic 回归模型评估出生体重与晚年患糖尿病的风险之间的关系。
较低或较高的出生体重与糖尿病风险增加相关。与出生体重为 2500 至 3499 克的个体相比，出生体重<2500 克、3500 至 3999 克和≥4000 克的个体患糖尿病的比值比（OR）和 95%置信区间（CI）分别为 1.28（1.11-1.47）、1.11（1.04-1.19）和 1.20（1.07-1.34）。在当前 BMI≥24kg/m2的参与者中，这种关联显著，但在 BMI 正常的参与者中未检测到（OR 1.20 [95%CI 0.96-1.49]、1.11 [95%CI 0.98-1.25]和 1.10 [95%CI 0.89-1.37]）。此外，出生体重低但饮食习惯健康（OR 0.94；95%CI 0.68-1.29）或体力活动理想（OR 1.41；95%CI 0.97-2.04）的个体患糖尿病的风险并未增加。
出生体重与糖尿病风险之间存在 U 型关联。健康的生活方式（健康的饮食习惯或理想的体力活动）可能消除低出生体重对糖尿病发展的负面影响，但不能消除高出生体重的影响。
