| 樊诗琦,严双琴,朱贝贝,李小真,童娟,李春刚,曹慧,伍晓艳,谢亮亮,魏兆莲,陶芳标.孕前BMI和妊娠期糖尿病对儿童脂肪重积聚时相提前的独立和联合效应[J].Chinese journal of Epidemiology,2022,43(10):1626-1631 |
| 孕前BMI和妊娠期糖尿病对儿童脂肪重积聚时相提前的独立和联合效应 |
| Independent and combined effects of pre-pregnancy BMI and gestational diabetes on early adiposity rebound timing in children |
| Received:April 29, 2022 |
| DOI：10.3760/cma.j.cn112338-20220429-00364 |
| KeyWord: 妊娠期糖尿病 体质指数 超重 肥胖 脂肪重积聚 |
| English Key Word: Gestational diabetes Body mass index Overweight Obesity Adiposity rebound |
| FundProject:安徽省重点研究与开发计划（202104j07020034）；国家自然科学基金（82073564） |
| Author Name | Affiliation | E-mail | | Fan Shiqi | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Yan Shuangqin | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China
Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | 470862302@qq.com | | Zhu Beibei | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Li Xiaozhen | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Tong Juan | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Li Chungang | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Cao Hui | Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | | | Wu Xiaoyan | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Xie Liangliang | Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | | | Wei Zhaolian | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | | | Tao Fangbiao | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China | |
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| Abstract: |
| 目的 探讨孕前BMI、妊娠期糖尿病（GDM）与儿童脂肪重积聚（AR）时相提前的关联。方法 基于已经建立的马鞍山优生优育队列，本研究共纳入2 896对母子对，收集孕妇孕前身高、体重、24~28周GDM情况，在婴儿42天、3月龄、6月龄、9月龄以及1岁后每6个月进行1次随访，连续追踪随访至6岁，获得其身长/高、体重等资料。采用多因素logistic回归分析孕前BMI、GDM与儿童AR时相提前的关联强度，并通过相乘、相加模型分析孕前BMI及GDM对于儿童AR时相提前的发生是否存在交互作用。结果 母亲孕前体重不足、体重正常、超重和肥胖者分别占23.2%（672例）、66.4%（1 923例）、8.7%（251例）和1.7%（50例）；GDM患病率为12.4%。儿童AR年龄为（4.38±1.08）岁，AR时相提前的儿童占39.3%。多因素logistic回归结果显示，孕前超重（OR=1.67，95%CI：1.27~2.19）、肥胖（OR=3.05，95%CI：1.66~5.56）以及孕期患有GDM（OR=1.40，95%CI：1.11~1.76）是AR时相提前发生的危险因素，而孕前体重不足（OR=0.60，95%CI：0.49~0.73）是AR时相提前发生的保护因素。与仅孕前超重/肥胖或孕期患有GDM相比，孕前超重/肥胖与孕期患有GDM并存，AR时相提前的发生风险更高，OR值（95%CI）分别为2.03（1.20~3.44）、3.43（1.06~11.12）。相乘模型和相加模型分析显示，孕前BMI和孕期患有GDM对儿童AR时相提前无交互作用。结论 母亲孕前较高的BMI和孕期患有GDM是儿童AR时相提前发生的独立危险因素，两者并存的风险更高，但无统计学交互作用。 |
| English Abstract: |
| Objective To examine the independent and combined effects of pre-pregnancy BMI and gestational diabetes (GDM) on early adiposity rebound (AR) timing in children.Methods Based on the "Ma'anshan Birth Cohort Study", 2 896 eligible maternal and infant pairs were recruited. In the cohort, we collected pre-pregnancy height, weight, 24 to 28 weeks GDM diagnosis, follow-up at 42 days, three months, six months, nine months of age, and every six months after one year of age, and continuously followed up to 6 years old, and obtained the child's length/height, weight, and other data. The intensity of the association between pre-pregnancy BMI, GDM, and early AR timing was analyzed by the multivariate logistic regression model. Multiplication and additive models were used to analyze how pre-pregnancy BMI and GDM influenced early AR timing in children.Results The prevalence of underweight, average weight, overweight, and obesity before pregnancy were 23.2% (672), 66.4% (1 923), 8.7% (251), and 1.7% (50). The prevalence of GDM was 12.4%. We found that 39.3% of children had AR, and the average age at AR was (4.38±1.08). The results of multifactorial logistic regression analysis showed that pre-pregnancy overweight (OR=1.67, 95%CI:1.27-2.19), pre-pregnancy obesity (OR=3.05, 95%CI:1.66-5.56), and maternal GDM (OR=1.40, 95%CI:1.11-1.76) were risk factors for early AR timing in children. In contrast, pre-pregnancy underweight (OR=0.60, 95%CI:0.49-0.73) was a protective factor for early AR timing in children. Compared with the different effects of pre-pregnancy overweight/obesity and maternal GDM alone, the combined effect caused a higher risk of early AR timing in children, with OR values (95%CI) were 2.03 (1.20-3.44), 3.43 (1.06-11.12), respectively. The multiplication and additive models showed no interaction between pre-pregnancy BMI and GDM-influenced early AR timing in children.Conclusion Higher pre-pregnancy BMI and maternal GDM are the independent risk factors for the early AR timing in children, and the co-occurrence of the two is higher risks, but there was no statistical interaction. |
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