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治疗妊娠期糖尿病可降低出生体重,但在生命的第一年对婴儿肥胖无影响。

Treating Gestational Diabetes Reduces Birth Weight but Does Not Affect Infant Adiposity Across the 1st Year of Life.

作者信息

Retnakaran Ravi, Ye Chang, Hanley Anthony J, Connelly Philip W, Sermer Mathew, Zinman Bernard, Hamilton Jill K

机构信息

Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada.

Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.

出版信息

Diabetes Care. 2022 May 1;45(5):1230-1238. doi: 10.2337/dc21-2640.

Abstract

OBJECTIVE

The continuum of maternal glycemia in pregnancy shows continuous associations with both 1) neonatal birth weight at delivery and 2) subsequent adiposity later in childhood. While treating gestational diabetes mellitus (GDM) can lower birth weight and thereby disrupt the former association, it is unclear if such treatment reduces childhood adiposity. Thus, we sought to compare anthropometry across the 1st year of life between infants born to women who were treated for GDM and those with lesser degrees of gestational dysglycemia (untreated).

RESEARCH DESIGN AND METHODS

Anthropometric measurements were performed at 3 months and 12 months of life in 567 infants born to women comprising the following four gestational glucose tolerance groups: 1) women with normoglycemia on both glucose challenge test (GCT) and oral glucose tolerance test (OGTT) in pregnancy; 2) women with an abnormal GCT but normal OGTT; 3) those with mild gestational impaired glucose tolerance; and 4) women treated for GDM.

RESULTS

Birth weight progressively increased across the three untreated groups but was lowest in women treated for GDM (P = 0.0004). Similarly, women treated for GDM had the lowest rate of macrosomia (P = 0.02). Conversely, however, there were no differences among the four groups in weight z score, length z score, weight-for-length z score, or BMI z score at either 3 months or 12 months (all P values = NS). Similarly, there were no differences among the groups in triceps/biceps/subscapular/suprailiac skinfold thickness or sum of skinfolds at either 3 months or 12 months (all P values = NS).

CONCLUSIONS

Despite reducing birth weight and macrosomia, the treatment of GDM does not have analogous effects on infant adiposity across the 1st year of life.

摘要

目的

孕期母体血糖连续变化与以下两方面均呈现持续关联:1)分娩时新生儿出生体重;2)儿童期后期的肥胖程度。虽然治疗妊娠期糖尿病(GDM)可降低出生体重,从而打破前一种关联,但尚不清楚这种治疗能否降低儿童期肥胖。因此,我们试图比较GDM治疗组产妇所生婴儿与妊娠期血糖异常程度较轻(未治疗)产妇所生婴儿在出生后第一年的人体测量数据。

研究设计与方法

对567名婴儿在3个月和12个月时进行人体测量,这些婴儿的母亲分为以下四个妊娠期葡萄糖耐量组:1)孕期葡萄糖耐量试验(GCT)和口服葡萄糖耐量试验(OGTT)均为血糖正常的女性;2)GCT异常但OGTT正常的女性;3)轻度妊娠期糖耐量受损的女性;4)接受GDM治疗的女性。

结果

在三个未治疗组中,出生体重逐渐增加,但接受GDM治疗的女性所生婴儿出生体重最低(P = 0.0004)。同样,接受GDM治疗的女性巨大儿发生率最低(P = 0.02)。然而,相反的是,在3个月或12个月时,四组婴儿的体重Z评分、身长Z评分、身长体重Z评分或BMI Z评分均无差异(所有P值 = 无统计学意义)。同样,在3个月或12个月时,四组婴儿的肱三头肌/肱二头肌/肩胛下/髂上皮肤褶厚度或皮肤褶总和也无差异(所有P值 = 无统计学意义)。

结论

尽管治疗GDM可降低出生体重和巨大儿发生率,但在婴儿出生后的第一年,GDM治疗对婴儿肥胖并无类似影响。

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