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孕期母体血糖与儿童 5 岁时的肥胖和瘦素有关。

Maternal glucose in pregnancy is associated with child's adiposity and leptin at 5 years of age.

机构信息

Faculty of Medicine and Health Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.

Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.

出版信息

Pediatr Obes. 2021 Sep;16(9):e12788. doi: 10.1111/ijpo.12788. Epub 2021 Mar 16.

Abstract

BACKGROUND

Exposure to maternal hyperglycaemia in pregnancy has been associated with childhood obesity. Leptin regulation might be involved in this 'adiposity programming' and may depend on timing of exposure.

OBJECTIVES

To investigate associations of maternal glycaemia at different periods in pregnancy with childhood adiposity and leptin levels at 5 years of age.

METHODS

In a prospective pre-birth cohort, we measured maternal glucose levels after a 50 g oral glucose challenge test at first trimester (9.8 ± 2.3 weeks) and during a 75 g oral glucose tolerance test at second trimester (26.5 ± 0.9 weeks). We followed up children at 5 years; we measured anthropometry and body composition using dual-energy X-ray absorptiometry (DXA). We measured fasting leptin levels using immunoassays (Luminex) in 328 children. We conducted linear regression analyses, adjusting for potential confounders.

RESULTS

Maternal glycaemia at first trimester was associated with childhood leptin levels at 5 years, independently of maternal pre-pregnancy BMI and other confounders (β = .09 ± .04; P = .03). Higher post-load glucose levels at second trimester were associated with greater total body fat percentage measured by DXA (1 hour-glucose: β = .010 ± .004; P = .03 and 2 hours-glucose: β = .016 ± .005; P = .002), but not with leptin levels.

CONCLUSIONS

Our results suggest that programming of leptin regulation may be sensitive to maternal hyperglycaemia specifically in early pregnancy.

摘要

背景

孕期暴露于母体高血糖与儿童肥胖有关。瘦素调节可能与这种“肥胖编程”有关,并且可能取决于暴露的时间。

目的

研究孕期不同时期母体血糖与儿童 5 岁时肥胖和瘦素水平的相关性。

方法

在一项前瞻性产前队列研究中,我们在孕早期(9.8±2.3 周)和孕中期(26.5±0.9 周)进行 75g 口服葡萄糖耐量试验时测量了母体葡萄糖水平。我们在 5 岁时对儿童进行了随访;我们使用双能 X 线吸收法(DXA)测量了人体测量学和身体成分。我们使用免疫测定法(Luminex)测量了 328 名儿童的空腹瘦素水平。我们进行了线性回归分析,调整了潜在的混杂因素。

结果

孕早期母体血糖与儿童 5 岁时的瘦素水平独立相关,与母体孕前 BMI 和其他混杂因素无关(β=0.09±0.04;P=0.03)。孕中期负荷后血糖水平较高与 DXA 测量的总体脂肪百分比增加有关(1 小时葡萄糖:β=0.010±0.004;P=0.03 和 2 小时葡萄糖:β=0.016±0.005;P=0.002),但与瘦素水平无关。

结论

我们的结果表明,瘦素调节的编程可能对孕早期母体高血糖特别敏感。

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