Branda Julia Ines F, de Almeida-Pititto Bianca, Bensenor Isabela, Lotufo Paulo A, Ferreira Sandra Roberta G
Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil.
Front Endocrinol (Lausanne). 2022 Mar 14;13:842233. doi: 10.3389/fendo.2022.842233. eCollection 2022.
Adverse intrauterine environment-reflected by low birth weight (LBW)-has been linked to insulin resistance and type 2 diabetes later in life. Whether β-cell function reduction and insulin resistance could be detected even in middle-aged adults without overt diabetes is less investigated. We examined the association of LBW with β-cell function and insulin sensitivity in non-diabetic middle-aged adults from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
This is a cross-sectional analysis of 2,634 ELSA-Brasil participants aged between 34 and 59 years, without diabetes. Participants were stratified according to LBW defined as <2.5 kg and their clinical data were compared. HOMA-IR, HOMA-β, HOMA-adiponectin, TyG index, QUICKI and TG/HDL were calculated and their association with LBW were tested using multiple linear regression including adjustments suggested by Directed Acyclic Graphs and propensity score matching was applied.
The sample (47.4 ± 6.3 years) was composed of 57.5% of women and 9% had LBW. Subjects with LBW and normal-weight reported similar BMI values at the age of 20 years and current BMI was slightly lower in the LBW group. In average, cardiometabolic risk profile and also indexes of β-cell function and insulin sensitivity were within normal ranges. In regression analysis, log-transformed HOMA-β-but not with the other indexes-was associated with LBW (p = 0.014) independent of sex, skin color, prematurity, and family history of diabetes. After applying propensity-score matching in a well-balanced sample, HOMA-AD and TG/HDL indexes were associated with LBW.
The association between LBW and insulin sensitivity markers may occur in healthy middle-aged adults before overt glucose metabolism disturbances. Our data are coherent with the detection of early life events consequent with insulin resistance markers that could contribute to the risk of glucose metabolism disturbances.
低出生体重（LBW）所反映的不良宫内环境与日后生活中的胰岛素抵抗和2型糖尿病有关。在没有明显糖尿病的中年成年人中，是否能检测到β细胞功能降低和胰岛素抵抗的情况，相关研究较少。我们在巴西成人健康纵向研究（ELSA - Brasil）中，研究了非糖尿病中年成年人中低出生体重与β细胞功能和胰岛素敏感性之间的关联。
这是一项对2634名年龄在34至59岁之间、无糖尿病的ELSA - Brasil参与者的横断面分析。参与者根据定义为<2.5kg的低出生体重进行分层，并比较他们的临床数据。计算稳态模型评估的胰岛素抵抗指数（HOMA - IR）、稳态模型评估的β细胞功能指数（HOMA - β）、稳态模型评估的脂联素指数（HOMA - adiponectin）、TyG指数、定量胰岛素敏感性检查指数（QUICKI）和甘油三酯/高密度脂蛋白（TG/HDL），并使用包括有向无环图建议的调整在内的多元线性回归测试它们与低出生体重的关联，并应用倾向得分匹配。
样本（47.4±6.3岁）中女性占57.5%，9%有低出生体重。低出生体重者和正常体重者在20岁时报告的体重指数（BMI）值相似，且低出生体重组当前的BMI略低。总体而言，心血管代谢风险概况以及β细胞功能和胰岛素敏感性指标均在正常范围内。在回归分析中，经对数转换的HOMA - β（而非其他指标）与低出生体重相关（p = 0.014），且不受性别、肤色、早产和糖尿病家族史的影响。在经过倾向得分匹配的均衡样本中，HOMA - AD和TG/HDL指标与低出生体重相关。
在明显的糖代谢紊乱出现之前，低出生体重与胰岛素敏感性标志物之间的关联可能在健康的中年成年人中出现。我们的数据与检测到与胰岛素抵抗标志物相关的早期生活事件一致，并可能导致糖代谢紊乱风险增加。
