出生重量指数对中年罹患代谢综合征的预测作用  

Ponderal index at birth predicts metabolic syndrome in mid-aged Chinese

作　　者：米杰[1] 程红[1] 赵小元[1] 张志坤[2] 丁秀原[1] 侯冬青[1] 张孔来[3] 

机构地区：[1]首都儿科研究所流行病学研究室,北京100020 [2]华北煤炭医学院流行病学教研室 [3]中国医学科学院基础医学研究所中国协和医科大学基础医学院流行病学教研室

出　　处：《中华预防医学杂志》2004年第4期221-225,共5页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金资助项目 (3 9970 65 8) ;国家 973计划项目 (2 0 0 1CB5 10 3 0 5 ) ;北京市科技计划重点项目 (H0 3 0 93 0 0 3 0 13 0 )

摘　　要：目的　探讨出生重量指数与中年期罹患代谢综合征 (MS)的联系。方法　对 975名“宫内发育与成人疾病”队列研究人群 (男 4 94人、女 4 81人 ,年龄 4 1～ 5 2岁 )的身高、体重、血压和血脂进行了测定 ,并用稳态模式评估法计算胰岛素抵抗指数。根据 1999年WHO定义进行MS诊断。采用多因素logistic回归方法分析出生重量指数对中年期MS患病风险的预测作用 ,及其与成年体重指数的交互作用。结果　人群MS检出率为 180例 (18 7% ) ,出生重量指数 <P2 5、P2 5～、P50 ～和≥P75四分位组的MS检出率分别为 2 4 8%、19 4 %、16 3%和 14 0 % ,控制性别后趋势检验的差异有非常显著性。logistic回归分析结果显示 ,出生重量指数和成年体重指数同为MS的影响因素 ,出生时消瘦 (出生重量指数 <P2 5)与成年时超重 (体重指数≥ 2 4kg/m2 )之间存在协同作用 ,单纯的成年时超重罹患MS的危险度为 16 0 ,而出生时消瘦与成年时超重同时存在罹患MS的危险度为 2 9 1,其中 34 6 %归因于两因素的交互作用。结论　出生时消瘦是成年罹患MS的危险因素 ,是体重指数联系MS环节中的效应修正因子 ,即出生时消瘦同时伴有成年时超重的个体罹患MS风险最高。Objective To examine the association between Ponderal index (PI) at birth and metabolic syndrome during middle age. Methods Totally,975 adults (494 men and 481 women ) aged 41—52 from the study cohort of Fetal Origin of Adult Disease were recruited in the study for clinic examinations,involving anthropometry and measurements of blood pressure,fasting and 2 hr plasma levels of glucose and insulin,serum lipid profile. Their HOMA-insulin resistance (IR) index was estimated. Metabolic syndrome (MS) was diagnosed according to 1999 WHO definition. Multivariate logistic regression analysis was used to estimate the effect of PI on MS and the interaction between PI at birth and body mass index (BMI) in adulthood. Results Prevalence of MS was 18.7% in this mid-aged population,24.8%,19.4%,16.3% and 14.0% in those with less than the 25th percentile,the 25th to less than the 50th percentile,the 50th to less than the 75th percentile and more than 75th percentile of PI at birth,respectively,in a decreasing trend (χ 2 M-H for trend =9.938 adjusted for gender, P =0.002). Logistic regression analysis showed that both PI at birth and BMI during adulthood could influence their occurrence of MS ( β =-0.125,P =0.002,for PI;and β =0.430, P =0.000,for BMI). A synergistic effect between PI at birth and BMI in adulthood was observed in this population. Persons who were thin at birth with PI less than the 25 th percentile,and became overweight with BMI greater than or equal to 24 kg/m 2 later in their life,were at higher risk of suffering from metabolic syndrome ( OR =29.1,95% CI =13.6—62.1),in comparison with those who became overweight during adulthood from a higher PI at birth ( OR =16.0,95% CI =7.9—32.3) and those who were thin at birth and remained a appropriate BMI during their adulthood ( OR =2.0,95% CI =0.7—5.7). Attributable fraction of the interaction to MS was 34.6%. Conclusions Thin at birth was a predictor for later occurrence of metabolic syndrome,as well as an effect modifier for the association between of

关 键 词：出生重量指数 中年人 代谢综合征 预测作用 

分 类 号：R58[医药卫生—内分泌]