School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Diabet Med. 2023 Nov;40(11):e15204. doi: 10.1111/dme.15204. Epub 2023 Aug 26.
To investigate the associations between gestational diabetes mellitus (GDM) metformin or insulin treatment and offspring growth trajectories from 0 to 60 months.
Participants were from the Born in Bradford birth cohort study. Using covariate-adjusted multilevel linear spline models (4 splines: 0-1.6, 1.6-6, 6-17 and 17-60 months), we compared weight, height and body mass index (BMI) z-score trajectories of: (1) 76 offspring exposed to metformin (OGDM-Metformin) and 420 offspring exposed to insulin (OGDM-Insulin); (2) OGDM-Metformin and 9171 offspring not exposed to GDM (No-GDM); (3) OGDM-Insulin and No-GDM.
(1) OGDM-Metformin had comparable growth trajectories to OGDM-Insulin from 0 to 60 months. (2) OGDM-Metformin had a lower mean birthweight z-score than No-GDM. OGDM-Metformin had faster changes in height z-score (0.13 [95% CI 0.026, 0.24]) from 17 to 60 months and by 60 months, had comparable mean BMI z-score to No-GDM. (3) OGDM-insulin had lower mean birthweight and height z-scores than No-GDM. OGDM-Insulin had faster changes in weight (0.32 [0.021, 0.62]) and height (0.50 [0.087, 0.91]) from 1.6 to 6 months and by 60 months, had comparable mean BMI z-score to No-GDM.
GDM metformin treatment was not associated with differences in offspring growth trajectories compared to insulin treatment. Both metformin and insulin-exposed offspring had comparable BMI z-score to No-GDM by 60 months.
研究妊娠糖尿病(GDM)二甲双胍或胰岛素治疗与 0 至 60 个月时后代生长轨迹之间的关系。
参与者来自布拉德福德出生队列研究。使用协变量调整的多层次线性样条模型(4 个样条:0-1.6、1.6-6、6-17 和 17-60 个月),我们比较了体重、身高和体重指数(BMI)Z 分数轨迹:(1)76 名暴露于二甲双胍的后代(OGDM-二甲双胍)和 420 名暴露于胰岛素的后代(OGDM-胰岛素);(2)OGDM-二甲双胍和 9171 名未暴露于 GDM 的后代(No-GDM);(3)OGDM-胰岛素和 No-GDM。
(1)OGDM-二甲双胍与 OGDM-胰岛素在 0 至 60 个月时具有相似的生长轨迹。(2)OGDM-二甲双胍的平均出生体重 Z 分数低于 No-GDM。OGDM-二甲双胍的身高 Z 分数变化更快(0.13[95%CI0.026,0.24]),从 17 至 60 个月,到 60 个月时,与 No-GDM 的平均 BMI Z 分数相当。(3)OGDM-胰岛素的平均出生体重和身高 Z 分数均低于 No-GDM。OGDM-胰岛素的体重(0.32[0.021,0.62])和身高(0.50[0.087,0.91])从 1.6 至 6 个月的变化更快,到 60 个月时,与 No-GDM 的平均 BMI Z 分数相当。
与胰岛素治疗相比,二甲双胍治疗 GDM 并不与后代生长轨迹的差异相关。二甲双胍和胰岛素暴露的后代到 60 个月时的 BMI Z 分数与 No-GDM 相当。