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不同发育阶段妊娠期糖尿病女性后代超重的风险:一项涉及超过50万后代的荟萃分析

Risks of overweight in the offspring of women with gestational diabetes at different developmental stages: A meta-analysis with more than half a million offspring.

作者信息

Gao Ming, Cao Shu, Li Ninghua, Liu Jinnan, Lyu Yuanjun, Li Jing, Yang Xilin

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.

Department of Endocrinology, Tianjin Hospital, Tianjin, China.

出版信息

Obes Rev. 2022 Mar;23(3):e13395. doi: 10.1111/obr.13395. Epub 2021 Nov 24.

Abstract

We conducted a meta-analysis to evaluate the association of maternal gestational diabetes mellitus (GDM) and offspring overweight from birth to adulthood, and to assess the effects of lifestyle interventions in women with GDM on this risk of offspring overweight. We identified literature from PubMed and 12 other electronic databases and retrieved relevant literature published before October 20, 2020. Random-effects model analysis was used to calculate relative risks (RRs) of overweight and weighted mean differences of body mass index among children stratified into different developmental stages. Forty-nine cohort studies (n = 559,377) and four randomized controlled trials (n = 1277) were included. We found that offspring of women with GDM were at an increased risk for overweight with age, from 1.14 (95% confidence interval [CI]: 1.06-1.22) under 5 years, 1.37 (95% CI: 1.31-1.44) at 5 to <10 years, 2.00 (95% CI: 1.79-2.23) at 10 to <18 years, to 2.05 (95% CI: 1.65-2.55) over 18 years of age (p < 0.05 for differences among groups). However, it was not observed that lifestyle interventions for GDM decreased the elevated overweight risk (RR: 0.94, 95% CI: 0.80-1.11, I  = 0.0%). These findings highlight the need for adopting an active and healthy lifestyle in this high-risk group.

摘要

我们进行了一项荟萃分析,以评估母亲妊娠期糖尿病(GDM)与子代从出生到成年期超重之间的关联,并评估GDM女性的生活方式干预对其子代超重风险的影响。我们从PubMed和其他12个电子数据库中检索文献,并获取了2020年10月20日前发表的相关文献。采用随机效应模型分析计算不同发育阶段儿童超重的相对风险(RRs)和体重指数的加权平均差异。纳入了49项队列研究(n = 559,377)和4项随机对照试验(n = 1277)。我们发现,GDM女性的子代超重风险随年龄增加,5岁以下为1.14(95%置信区间[CI]:1.06 - 1.22),5至<10岁为1.37(95% CI:1.31 - 1.44),10至<18岁为2.00(95% CI:1.79 - 2.23),18岁以上为2.05(95% CI:1.65 - 2.55)(组间差异p < 0.05)。然而,未观察到针对GDM的生活方式干预降低了升高的超重风险(RR:0.94,95% CI:0.80 - 1.11,I² = 0.0%)。这些发现凸显了在这一高危人群中采取积极健康生活方式的必要性。

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