儿童和青少年时期的体重跟踪与 2 型糖尿病风险。
Weight tracking in childhood and adolescence and type 2 diabetes risk.
机构信息
Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA.
出版信息
Diabetologia. 2020 Sep;63(9):1753-1763. doi: 10.1007/s00125-020-05165-w. Epub 2020 May 18.
AIMS/HYPOTHESIS: The aim of this work was to examine the associations of average weight and weight velocity in three growth periods from birth through adolescence with type 2 diabetes incidence.
METHODS
Child participants were selected from a 43 year longitudinal study of American Indians to represent three growth periods: pre-adolescence (birth to 8 years); early adolescence (8 to 13 years); and late adolescence (13 to ~18 years). Age-, sex- and height-standardised weight z score mean and weight z score velocity (change/year) were computed for each period. Participants were followed for up to 25 years from the end of each growth period until they developed diabetes. Associations of weight z score mean or weight z score velocity with diabetes incidence were determined with sex-, birth date- and maternal diabetes-adjusted Poisson regression models.
RESULTS
Among 2100 participants representing the pre-adolescence growth period, 1558 representing the early adolescence period and 1418 representing the late adolescence period, there were 290, 315 and 380 incident diabetes cases, respectively. During the first 10 years of follow-up, the diabetes incidence rate ratio (95% CI) was 1.72 (1.40, 2.11)/SD of log weight z score mean in pre-adolescence, 2.09 (1.68, 2.60)/SD of log weight z score mean in early adolescence and 1.85 (1.58, 2.17)/SD of log weight z score mean in late adolescence. The diabetes incidence rate ratio (95% CI) was 1.79 (1.49, 2.17)/SD of log weight z score velocity in pre-adolescence, 1.13 (0.91, 1.41)/SD of log weight z score velocity in early adolescence and 1.29 (1.09, 1.51)/SD of log weight z score velocity in late adolescence. There were strong correlations in the weight z score means and weak correlations in the weight z score velocities between successive periods.
CONCLUSIONS/INTERPRETATION: Higher weight and accelerated weight gain in all growth periods associate with increased type 2 diabetes risk. Importantly, higher weight and greater weight velocity during pre-adolescence jointly associate with the highest type 2 diabetes risk. Graphical abstract.
目的/假设：本研究旨在探讨从出生到青春期三个生长阶段的平均体重和体重增长率与 2 型糖尿病发病的相关性。
方法
从一项为期 43 年的美国印第安人纵向研究中选择儿童参与者，以代表三个生长阶段：青春期前（出生至8 岁）；青春期早期（8 至13 岁）；青春期晚期（13 至~18 岁）。为每个阶段计算年龄、性别和身高标准化体重 z 分数均值和体重 z 分数增长率（每年变化）。从每个生长阶段结束到参与者发生糖尿病的随访时间最长可达 25 年。使用性别、出生日期和母亲糖尿病调整的泊松回归模型确定体重 z 分数均值或体重 z 分数增长率与糖尿病发病的相关性。
结果
在代表青春期前生长阶段的 2100 名参与者、代表青春期早期生长阶段的 1558 名参与者和代表青春期晚期生长阶段的 1418 名参与者中，分别有 290、315 和 380 例糖尿病发病。在最初 10 年的随访期间，青春期前体重 z 分数均值每增加一个标准差（SD）的糖尿病发病风险比（95%CI）为 1.72（1.40，2.11），青春期早期体重 z 分数均值每增加一个 SD 的糖尿病发病风险比为 2.09（1.68，2.60），青春期晚期体重 z 分数均值每增加一个 SD 的糖尿病发病风险比为 1.85（1.58，2.17）。青春期前体重 z 分数增长率每增加一个 SD 的糖尿病发病风险比（95%CI）为 1.79（1.49，2.17），青春期早期体重 z 分数增长率每增加一个 SD 的糖尿病发病风险比为 1.13（0.91，1.41），青春期晚期体重 z 分数增长率每增加一个 SD 的糖尿病发病风险比为 1.29（1.09，1.51）。连续阶段之间体重 z 分数均值存在较强的相关性，而体重 z 分数增长率之间存在较弱的相关性。
结论/解释：所有生长阶段的体重增加和体重增长率增加都与 2 型糖尿病风险增加相关。重要的是，青春期前体重增加和体重增长率增加与最高的 2 型糖尿病风险相关。
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