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孕前生活方式干预对儿童心脏代谢健康的影响——一项随机对照试验的随访研究。

The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health-Follow-Up of a Randomized Controlled Trial.

机构信息

Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands.

Department of Obstetrics and Gynecology, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands.

出版信息

Cells. 2021 Dec 24;11(1):41. doi: 10.3390/cells11010041.

Abstract

Maternal obesity is associated with adverse metabolic outcomes in her offspring, from the earliest stages of development leading to obesity and poorer cardiometabolic health in her offspring. We investigated whether an effective preconception lifestyle intervention in obese women affected cardiometabolic health of their offspring. We randomly allocated 577 infertile women with obesity to a 6-month lifestyle intervention, or to prompt infertility management. Of the 305 eligible children, despite intensive efforts, 17 in the intervention and 29 in the control group were available for follow-up at age 3-6 years. We compared the child's Body Mass Index (BMI) Z score, waist and hip circumference, body-fat percentage, blood pressure Z scores, pulse wave velocity and serum lipids, glucose and insulin concentrations. Between the intervention and control groups, the mean (±SD) offspring BMI Z score (0.69 (±1.17) vs. 0.62 (±1.04)) and systolic and diastolic blood pressure Z scores (0.45 (±0.65) vs. 0.54 (±0.57); 0.91 (±0.66) vs. 0.96 (±0.57)) were similar, although elevated compared to the norm population. We also did not detect any differences between the groups in the other outcomes. In this study, we could not detect effects of a preconception lifestyle intervention in obese infertile women on the cardiometabolic health of their offspring. Low follow-up rates, perhaps due to the children's age or the subject matter, combined with selection bias abating contrast in periconceptional weight between participating mothers, hampered the detection of potential effects. Future studies that account for these factors are needed to confirm whether a preconception lifestyle intervention may improve the cardiometabolic health of children of obese mothers.

摘要

母亲肥胖与后代不良代谢结局相关,从发育早期开始,导致后代肥胖和较差的心血管代谢健康。我们研究了肥胖女性的有效孕前生活方式干预是否会影响其后代的心血管代谢健康。我们将 577 名肥胖不孕妇女随机分配到为期 6 个月的生活方式干预组或即时不孕管理组。在 305 名符合条件的儿童中,尽管进行了密集的努力,干预组中有 17 名和对照组中有 29 名儿童在 3-6 岁时可进行随访。我们比较了儿童的体重指数(BMI)Z 评分、腰围和臀围、体脂百分比、血压 Z 评分、脉搏波速度和血清脂质、血糖和胰岛素浓度。与对照组相比,干预组和对照组儿童的 BMI Z 评分(0.69(±1.17)比 0.62(±1.04))和收缩压和舒张压 Z 评分(0.45(±0.65)比 0.54(±0.57);0.91(±0.66)比 0.96(±0.57))相似,尽管与正常人群相比仍偏高。我们也没有发现两组在其他结果上的差异。在这项研究中,我们无法检测到肥胖不孕妇女的孕前生活方式干预对其后代心血管代谢健康的影响。低随访率,可能是由于儿童的年龄或主题,以及参与母亲之间的围孕期体重差异导致的选择偏倚减弱,阻碍了潜在效果的检测。需要未来的研究来确认孕前生活方式干预是否可以改善肥胖母亲的孩子的心血管代谢健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b65/8750944/446babfd60dc/cells-11-00041-g001.jpg

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