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母源性肥胖和妊娠期糖尿病对子代身体成分和左心室质量的跨代影响:芬兰妊娠期糖尿病预防研究(RADIEL)6 年随访。

Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6-year follow-up.

机构信息

Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Department of Congenital Heart Defects and Pediatric Cardiology, SMDZ in Zabrze, SUM, Katowice, Poland.

出版信息

Diabet Med. 2020 Jan;37(1):147-156. doi: 10.1111/dme.14089. Epub 2019 Aug 2.

Abstract

AIM

To investigate the influence of maternal adiposity and gestational diabetes on offspring body composition and left ventricle mass in early childhood.

METHODS

The observational follow-up study included 201 mother-child pairs, a sub-cohort from the Finnish Gestational Diabetes Prevention Study, who were recruited 6.1 ± 0.5 (mean ± SD) years postpartum, aiming for an equal number of mothers with and without gestational diabetes.

RESULTS

Maternal pre-pregnancy BMI (mean ± SD; 30.5 ± 5.6 kg/m ) was associated with child body fat percentage [0.26 (95% CI; 0.08, 0.44)% increase in child body fat per 1 kg/m increase in pre-pregnancy BMI of mothers with obesity] and was reflected in child BMI Z-score (mean ± SD; 0.45 ± 0.93). Left ventricle mass, left ventricle mass index and left ventricle mass Z-score were not associated with gestational diabetes, pre-pregnancy BMI or child body fat percentage. After adjusting for child sex, body fat percentage, systolic blood pressure, pre-pregnancy BMI and maternal lean body mass, left ventricle mass increased by 3.08 (95% CI; 2.25, 3.91) g for each 1 kg in child lean body mass.

CONCLUSIONS

Left ventricle mass at 6 years of age is determined predominantly by lean body mass. Maternal pre-gestational adiposity is reflected in child, but no direct association between left ventricle mass and child adiposity or evidence of left ventricle mass foetal programming related to gestational diabetes and maternal adiposity was observed in early childhood.

摘要

目的

探讨母体肥胖和妊娠期糖尿病对婴幼儿体成分和左心室质量的影响。

方法

本观察性随访研究纳入了来自芬兰妊娠期糖尿病预防研究的 201 对母婴对子,在产后 6.1 ± 0.5(均值 ± 标准差)年招募,旨在纳入等量的有和无妊娠期糖尿病的母亲。

结果

母亲孕前 BMI(均值 ± 标准差;30.5 ± 5.6 kg/m )与儿童体脂百分比相关[母亲肥胖时,儿童体脂百分比每增加 1 kg/m ,则增加 0.26(95%置信区间;0.08,0.44)%],并反映在儿童 BMI Z 评分(均值 ± 标准差;0.45 ± 0.93)上。左心室质量、左心室质量指数和左心室质量 Z 评分与妊娠期糖尿病、孕前 BMI 或儿童体脂百分比均无关。在校正了儿童性别、体脂百分比、收缩压、孕前 BMI 和母亲瘦体重后,儿童瘦体重每增加 1 kg,左心室质量增加 3.08(95%置信区间;2.25,3.91)g。

结论

6 岁时的左心室质量主要由瘦体重决定。母体孕前肥胖反映在儿童中,但在婴幼儿期未观察到左心室质量与儿童肥胖之间存在直接关联,也未发现与妊娠期糖尿病和母体肥胖相关的左心室质量胎儿编程的证据。

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