出生体重与婴幼儿体格发育及糖脂代谢的相关性分析
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摘要
目的探讨出生体重(BW)与婴幼儿体格发育及糖脂代谢的相关性,分析婴儿期体格追赶生长的影响因素。方法随机纳入母子配对样本1 064例,收集婴幼儿出生前后的一般情况、0～18月龄体格及喂养数据。检测脐血及18月龄静脉血糖脂代谢指标。结果新生儿BW与血清超敏C反应蛋白(hCRP)显著正相关,与甘油三酯(TG)显著负相关,且仅与女婴脂蛋白a(Lpa)显著正相关(P<0.05)。18月龄时,BW与男童空腹血糖(GLU)及女童高密度脂蛋白胆固醇(HDL-c)显著负相关(P<0.05)。BW与6月龄内体格增长显著负相关,低出生体重(LBW)在6月龄内的体格追赶生长幅度显著较高(P<0.01)。使婴儿6月龄体重指数Z分值(BMIZ)追赶生长加快的因素是BW过低、进食泥状及汁装辅食,使其减慢的因素是父亲高血压、吃奶时间较长、进食鱼虾类频率较高、家庭年收入较高。结论 BW过高或过低均对糖脂代谢产生不利影响。LBW婴儿6月龄内增长幅度显著较高,可能与远期代谢综合征(MS)风险增加有关。
Objective To investigate the correlation of birth weight(BW) with children′s physical development and glycolipid metabolism during infancy,and to analyze the influencing factors of infant catch-up growth. Methods A total of 1 064 mother-child pairs were randomly recruited and the perinatal baseline information,anthropometric indexes and feeding data of children aged 0 to 18 months were recorded. The neonatal cord blood and the venous blood of 18-month-old children were tested for glycolipid metabolism indexes. Results BW of newborns presented significantly positive correlation with serum high sensitivity C-reactive protein(hCRP) but negative correlation with triglyceride(TG),and positive correlation between BW with lipoprotein a(Lpa) was found only in female infants(P<0.05). At 18 months old,negative correlation was found between BW with fasting glucose(GLU) in male and high density lipoprotein cholesterol(HDL-c) in female(P<0.05). Within 6 months old,significantly negative correlation between BW and children′s physical development was detected,and low birth weight(LBW) infants showed significantly more physical catch-up growth(P<0.01). Lower BW,mashed and fluid supplementary food were found to be promoting factors of body mass index Z score(BMIZ)catch-up growth within 6 months old,while paternal hypertension,eating slowly,higher fish-species consumption frequency and higher family income were shown to be weakening factors for BMIZ catch-up growth. Conclusions Extremely high or low of BW is likely to have adverse effects on glycolipid metabolism. Significant higher BMIZ catch-up growth in LBW infants within 6 months old may increase the risk of metabolic syndrome(MS) in adulthood.
Objective To investigate the correlation of birth weight(BW) with children′s physical development and glycolipid metabolism during infancy,and to analyze the influencing factors of infant catch-up growth. Methods A total of 1 064 mother-child pairs were randomly recruited and the perinatal baseline information,anthropometric indexes and feeding data of children aged 0 to 18 months were recorded. The neonatal cord blood and the venous blood of 18-month-old children were tested for glycolipid metabolism indexes. Results BW of newborns presented significantly positive correlation with serum high sensitivity C-reactive protein(hCRP) but negative correlation with triglyceride(TG),and positive correlation between BW with lipoprotein a(Lpa) was found only in female infants(P<0.05). At 18 months old,negative correlation was found between BW with fasting glucose(GLU) in male and high density lipoprotein cholesterol(HDL-c) in female(P<0.05). Within 6 months old,significantly negative correlation between BW and children′s physical development was detected,and low birth weight(LBW) infants showed significantly more physical catch-up growth(P<0.01). Lower BW,mashed and fluid supplementary food were found to be promoting factors of body mass index Z score(BMIZ)catch-up growth within 6 months old,while paternal hypertension,eating slowly,higher fish-species consumption frequency and higher family income were shown to be weakening factors for BMIZ catch-up growth. Conclusions Extremely high or low of BW is likely to have adverse effects on glycolipid metabolism. Significant higher BMIZ catch-up growth in LBW infants within 6 months old may increase the risk of metabolic syndrome(MS) in adulthood.
引文
[1] Stansfield BK,Fain ME,Bhatia J,et al.Nonlinear relationship between birth weight and visceral fat in adolescents[J].J Pediatr,2016,174:185-192.
[2] Tam CH,Wang Y,Luan J,et al.Non-linear relationship between birthweight and cardiometabolic risk factors in Chinese adolescents and adults[J].Diabet Med,2015,32(2):220-225.
[3] Heindel JJ,Vandenberg LN.Developmental origins of health and disease:a paradigm for understanding disease cause and prevention[J].Curr Opin Pediatr,2015,27(2):248-253.
[4] de Jong M,Lafeber HN,Cranendonk A,et al.Components of the metabolic syndrome in early childhood in very-low-birth-weight infants[J].Horm Res Paediatr,2014,81(1):43-49.
[5] Santangeli L,Sattar N,Huda SS.Impact of maternal obesity on perinatal and childhood outcomes[J].Best Pract Res Clin Obstet Gynaecol 2015;29:438-448.
[6] Tang Q,Li X,Song P,et al.Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening:Developments in research and prospects for the future[J].Drug Discov Ther,2015,9(6):380-385.
[7] Pan HC,Sheu WH,Lee WJ,et al.Coronary severity score and C-reactive protein predict major adverse cardiovascular events in patients with stable coronary artery disease (from the Taichung CAD Study)[J].Clin Chim Acta,2015,445:93-100.
[8] Azadbakht L,Kelishadi R,Saraf-Bank S,et al.The association of birth weight with cardiovascular risk factors and mental problems among Iranian school-aged children:the CASPIAN-III study [J].Nutrition,2014,30(2):150-158.
[9] Mullett MD,Cottrell L,Lilly C,et al.Association between birth characteristics and coronary disease risk factors among fifth graders[J].J Pediatr,2014,164(1):78-82.
[10] Hou RL,Jin WY,Chen XY,et al.Cord blood C-peptide,insulin,HbA1c,and lipids levels in small-and large-for-gestational-age newborns[J].Med Sci Monit,2014,20:2097-2105.
[11] Finkielstain GP,Lui JC,Baron J.Catch-up growth:cellular and molecular mechanisms [J].World Rev Nutr Diet,2013,106:100-104.
[12] Brown LD,Hay WJ.Impact of placental insufficiency on fetal skeletal muscle growth[J].Mol Cell Endocrinol,2016,435:69-77.
[13] Kelishadi R,Haghdoost AA,Jamshidi F,et al.Low birthweight or rapid catch-up growth:which is more associated with cardiovascular disease and its risk factors in later life?A systematic review and cryptanalysis[J].Paediatr Int Child Health,2015,35(2):110-123.
[14] de Arriba A,Dominguez M,Labarta JI,et al.Metabolic syndrome and endothelial dysfunction in a population born small for gestational age relationship to growth and Gh therapy[J].Pediatr Endocrinol Rev,2013,10(3):297-307.
[15] Fujita Y,Kouda K,Nakamura H,et al.Association of rapid weight gain during early childhood with cardiovascular risk factors in Japanese adolescents[J].J Epidemiol,2013,23:103-108.
[16] Zhu B,Haruyama Y,Muto T,et al.Association between eating speed and metabolic syndrome in a three-year population-based cohort study[J].J Epidemiol,2015,25(4):332-336.
[17] Lee S,Ko BJ,GongY,etal.Self-reported eating speed in relation to non-alcoholic fatty liver disease in adults[J].Eur J Nutr,2015,55(1):327-333.
[18] Hermans R C,Hermsen S,Robinson E,et al.The effect of real-time vibrotactilefeedback delivered through an augmented fork on eating rate,satiation,and food intake[J].Appetite,2017,113:7-13.
[19] Meng L,Liang Y,Liu J,et al.Prevalence and risk factors of hypertension based on repeated measurements in Chinese children and adolescents[J].Blood Press,2013,22(1):59-64.
[20] Hillman S,Peebles DM,Williams DJ.Paternal metabolic and cardiovascular risk factors for fetal growth restriction:a case-control study[J].Diabetes Care,2013,36(6):1675-1680.
[21] Kakinami L,Gauvin L,Barnett T A,et al.Trying to lose weight:the association of income and age to weight-loss strategies in the U.S[J].Am J Prev Med,2014,46(6):585-592.
[22] 翟屹,夏代提古丽·苏拉衣曼,李伟荣,等.家庭社会经济地位与儿童超重肥胖的关系[J].中华预防医学杂志,2013(10):945-948.
[2] Tam CH,Wang Y,Luan J,et al.Non-linear relationship between birthweight and cardiometabolic risk factors in Chinese adolescents and adults[J].Diabet Med,2015,32(2):220-225.
[3] Heindel JJ,Vandenberg LN.Developmental origins of health and disease:a paradigm for understanding disease cause and prevention[J].Curr Opin Pediatr,2015,27(2):248-253.
[4] de Jong M,Lafeber HN,Cranendonk A,et al.Components of the metabolic syndrome in early childhood in very-low-birth-weight infants[J].Horm Res Paediatr,2014,81(1):43-49.
[5] Santangeli L,Sattar N,Huda SS.Impact of maternal obesity on perinatal and childhood outcomes[J].Best Pract Res Clin Obstet Gynaecol 2015;29:438-448.
[6] Tang Q,Li X,Song P,et al.Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening:Developments in research and prospects for the future[J].Drug Discov Ther,2015,9(6):380-385.
[7] Pan HC,Sheu WH,Lee WJ,et al.Coronary severity score and C-reactive protein predict major adverse cardiovascular events in patients with stable coronary artery disease (from the Taichung CAD Study)[J].Clin Chim Acta,2015,445:93-100.
[8] Azadbakht L,Kelishadi R,Saraf-Bank S,et al.The association of birth weight with cardiovascular risk factors and mental problems among Iranian school-aged children:the CASPIAN-III study [J].Nutrition,2014,30(2):150-158.
[9] Mullett MD,Cottrell L,Lilly C,et al.Association between birth characteristics and coronary disease risk factors among fifth graders[J].J Pediatr,2014,164(1):78-82.
[10] Hou RL,Jin WY,Chen XY,et al.Cord blood C-peptide,insulin,HbA1c,and lipids levels in small-and large-for-gestational-age newborns[J].Med Sci Monit,2014,20:2097-2105.
[11] Finkielstain GP,Lui JC,Baron J.Catch-up growth:cellular and molecular mechanisms [J].World Rev Nutr Diet,2013,106:100-104.
[12] Brown LD,Hay WJ.Impact of placental insufficiency on fetal skeletal muscle growth[J].Mol Cell Endocrinol,2016,435:69-77.
[13] Kelishadi R,Haghdoost AA,Jamshidi F,et al.Low birthweight or rapid catch-up growth:which is more associated with cardiovascular disease and its risk factors in later life?A systematic review and cryptanalysis[J].Paediatr Int Child Health,2015,35(2):110-123.
[14] de Arriba A,Dominguez M,Labarta JI,et al.Metabolic syndrome and endothelial dysfunction in a population born small for gestational age relationship to growth and Gh therapy[J].Pediatr Endocrinol Rev,2013,10(3):297-307.
[15] Fujita Y,Kouda K,Nakamura H,et al.Association of rapid weight gain during early childhood with cardiovascular risk factors in Japanese adolescents[J].J Epidemiol,2013,23:103-108.
[16] Zhu B,Haruyama Y,Muto T,et al.Association between eating speed and metabolic syndrome in a three-year population-based cohort study[J].J Epidemiol,2015,25(4):332-336.
[17] Lee S,Ko BJ,GongY,etal.Self-reported eating speed in relation to non-alcoholic fatty liver disease in adults[J].Eur J Nutr,2015,55(1):327-333.
[18] Hermans R C,Hermsen S,Robinson E,et al.The effect of real-time vibrotactilefeedback delivered through an augmented fork on eating rate,satiation,and food intake[J].Appetite,2017,113:7-13.
[19] Meng L,Liang Y,Liu J,et al.Prevalence and risk factors of hypertension based on repeated measurements in Chinese children and adolescents[J].Blood Press,2013,22(1):59-64.
[20] Hillman S,Peebles DM,Williams DJ.Paternal metabolic and cardiovascular risk factors for fetal growth restriction:a case-control study[J].Diabetes Care,2013,36(6):1675-1680.
[21] Kakinami L,Gauvin L,Barnett T A,et al.Trying to lose weight:the association of income and age to weight-loss strategies in the U.S[J].Am J Prev Med,2014,46(6):585-592.
[22] 翟屹,夏代提古丽·苏拉衣曼,李伟荣,等.家庭社会经济地位与儿童超重肥胖的关系[J].中华预防医学杂志,2013(10):945-948.