UWA Medical School, University of Western Australia, Perth, 6009 WA, Australia.
Nutrition Health Innovation Research Institute, Edith Cowan University, Perth, 6027 WA, Australia.
J Clin Endocrinol Metab. 2023 Aug 18;108(9):e861-e870. doi: 10.1210/clinem/dgad292.
Events during gestation greatly influence the risk of cardiometabolic diseases including diabetes in offspring during later life.
This study aimed to investigate relationships between serial ultrasound-derived fetal growth trajectories and markers of insulin resistance in young adults in the Raine Study, an Australian pregnancy cohort.
Linear mixed modeling examined the relationship between fetal growth trajectory groups, constructed using serial ultrasound-based abdominal circumference (AC), femur length (FL), and head circumference (HC) from 1333 mother-fetal pairs, and offspring Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), as a marker of diabetes risk, at 20 (n = 414), 22 (n = 385), and 27 (n = 431) years. Analyses were adjusted for age, sex, ethnicity, socioeconomic status, adult lifestyle factors, and maternal factors during pregnancy.
The study identified 7 AC, 5 FL, and 5 HC growth trajectory groups. Compared to the average-stable (reference) group, a low-falling AC growth trajectory (26%; P = .005) and 2 low HC growth trajectories (20%; P = .006% and 8%; P = .021) were associated with higher adult HOMA-IR. Trajectories representing a high-stable FL and a rising HC were associated with 12% (P = .002) and 9% (P = .021) lower adult HOMA-IR, respectively, compared to the reference group.
Restricted fetal HC and AC from early pregnancy are associated with higher relative insulin resistance in the offspring during adulthood. These data strengthen our understanding of the importance of the intrauterine environment and its effect on the risk of predisposition to adult diabetes and related metabolic disorders.
妊娠期间的事件极大地影响了后代在以后的生活中患心血管代谢疾病（包括糖尿病）的风险。
本研究旨在调查澳大利亚妊娠队列 Raine 研究中，通过胎儿生长的超声衍生系列轨迹与年轻成年人胰岛素抵抗标志物之间的关系。
线性混合模型检查了从 1333 对母婴中获得的基于超声的腹部周长（AC）、股骨长度（FL）和头围（HC）的系列胎儿生长轨迹组（共构建了 7 个 AC、5 个 FL 和 5 个 HC 生长轨迹组）与后代稳态模型评估的胰岛素抵抗（HOMA-IR）之间的关系，HOMA-IR 是糖尿病风险的标志物，分别在 20 岁（n = 414）、22 岁（n = 385）和 27 岁（n = 431）时进行测量。分析调整了年龄、性别、种族、社会经济地位、成年生活方式因素和妊娠期间的母亲因素。
研究确定了 7 个 AC、5 个 FL 和 5 个 HC 生长轨迹组。与平均稳定（参考）组相比，低下降 AC 生长轨迹（26%；P =.005）和 2 个低 HC 生长轨迹（20%；P =.006%和 8%；P =.021）与成人 HOMA-IR 较高相关。与参考组相比，代表高稳定 FL 和上升 HC 的轨迹分别与成年 HOMA-IR 降低 12%（P =.002）和 9%（P =.021）相关。
妊娠早期胎儿 HC 和 AC 的受限与后代成年期相对胰岛素抵抗增加有关。这些数据加强了我们对宫内环境及其对易感性的重要性的理解，易感性与成年期糖尿病和相关代谢紊乱的风险有关。
