母体脂代谢与新生儿肥胖有关：一项纵向研究。
Maternal Lipid Metabolism Is Associated With Neonatal Adiposity: A Longitudinal Study.
机构信息
Mother Infant Research Institute, Tufts Medical Center, Boston, MA 02111, USA.
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA.
出版信息
J Clin Endocrinol Metab. 2022 Aug 18;107(9):e3759-e3768. doi: 10.1210/clinem/dgac360.
CONTEXT
Pregnancy is characterized by progressive decreases in glucose insulin sensitivity. Low insulin sensitivity resulting in hyperglycemia is associated with higher neonatal adiposity. However, less is known regarding lipid metabolism, particularly lipid insulin sensitivity in pregnancy and neonatal adiposity.
OBJECTIVE
Because higher maternal prepregnancy body mass index is strongly associated with both hyperlipidemia and neonatal adiposity, we aimed to examine the longitudinal changes in basal and clamp maternal lipid metabolism as contributors to neonatal adiposity.
METHODS
Twelve women planning a pregnancy were evaluated before pregnancy, in early (12-14 weeks), and late (34-36 weeks) gestation. Body composition was estimated using hydrodensitometry. Basal and hyperinsulinemic-euglycemic clamp glucose and glycerol turnover (GLYTO) were measured using 2H2-glucose and 2H5-glycerol and substrate oxidative/nonoxidative metabolism with indirect calorimetry. Total body electrical conductivity was used to estimate neonatal body composition.
RESULTS
Basal free-fatty acids decreased with advancing gestation (P = 0.0210); however, basal GLYTO and nonoxidative lipid metabolism increased over time (P = 0.0046 and P = 0.0052, respectively). Further, clamp GLYTO and lipid oxidation increased longitudinally over time (P = 0.0004 and P = 0.0238, respectively). There was a median 50% increase and significant positive correlation during both basal and clamp GLYTO from prepregnancy through late gestation. Neonatal adiposity correlated with late pregnancy basal and clamp GLYTO (r = 0.6515, P = 0.0217; and r = 0.6051, P = 0.0371).
CONCLUSIONS
Maternal prepregnancy and late pregnancy measures of basal and clamp lipid metabolism are highly correlated. Late pregnancy basal and clamp GLYTO are significantly associated with neonatal adiposity and account for ~40% of the variance in neonatal adiposity. These data emphasize the importance of maternal lipid metabolism relating to fetal fat accrual.
背景
妊娠期间葡萄糖胰岛素敏感性逐渐下降。胰岛素敏感性降低导致的高血糖与新生儿肥胖有关。然而，关于脂代谢，尤其是妊娠期间的脂胰岛素敏感性和新生儿肥胖，人们知之甚少。
目的
由于较高的孕前母体体重指数与高脂血症和新生儿肥胖均密切相关，我们旨在研究基础和钳夹母体脂代谢的纵向变化，以作为新生儿肥胖的影响因素。
方法
对 12 名计划怀孕的女性在妊娠前、妊娠早期（12-14 周）和妊娠晚期（34-36 周）进行评估。通过水密度测定法评估身体成分。使用 2H2-葡萄糖和 2H5-甘油测量基础和高胰岛素正葡萄糖钳夹下的葡萄糖和甘油周转率（GLYTO），并通过间接热量法测量底物氧化/非氧化代谢。使用全身电导率估计新生儿的身体成分。
结果
基础游离脂肪酸随着妊娠的进展而降低（P=0.0210）；然而，基础 GLYTO 和非氧化脂代谢随时间增加（P=0.0046 和 P=0.0052）。此外，钳夹 GLYTO 和脂氧化随时间纵向增加（P=0.0004 和 P=0.0238）。在基础和钳夹 GLYTO 中，从孕前到妊娠晚期，中位数增加了 50%，且具有显著的正相关。新生儿肥胖与妊娠晚期基础和钳夹 GLYTO 相关（r=0.6515，P=0.0217；r=0.6051，P=0.0371）。
结论
母体孕前和妊娠晚期的基础和钳夹脂代谢指标高度相关。妊娠晚期的基础和钳夹 GLYTO 与新生儿肥胖显著相关，可解释新生儿肥胖 40%的变异。这些数据强调了母体脂代谢与胎儿脂肪积累的相关性。
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