出生体重与成年期肥胖指标联合效应对糖代谢异常的影响  

Joint effect of birth weight and obesity measures on abnormal glucose metabolism at adulthood

作　　者：席波[1] 程红[2] 陈芳芳[2] 赵小元[2] 米杰[2] 

机构地区：[1]山东大学公共卫生学院流行病学系,济南250012 [2]首都儿科研究所流行病学研究室

出　　处：《中华预防医学杂志》2016年第1期17-22,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（81172746）;北京市科技计划重大项目（D111100000611002）

摘　　要：目的分析出生体重分别与成年期BMI及腰围的联合效应，及其对糖代谢异常（包括糖尿病）的影响。方法采用历史性队列研究的设计方案，利用方便抽样方法，于1995和2001年分别选取1948年6月至1954年12月在北京协和医院出生的1921名婴儿为调查对象，通过北京市户籍管理系统获取其性别、年龄、出生体重、父/母亲糖尿病史、BMI、腰围、FPG和2hPG等成年期信息，将上述信息完整者纳入随访，共972名，其中1995年随访627名，2001年随访345名。根据出生体重将调查对象分为低出生体重、正常出生体重和高出生体重组。采用方差分析或x。检验比较不同出生体重调查对象的特征差异；采用多因素二分类非条件logistic回归模型分析出生体重、BMI和腰围对成年期糖代谢异常的单独影响效应；采用分层分析出生体重分别与成年期BMI及腰围对糖代谢异常影响的联合效应。结果972名调查对象中，男性493名，女性479名，年龄为（46．0±2．2）岁。低出生体重组的2hPG为（7．6±3．2）mmol／L，高于正常出生体重组[（6．9±2．1）mmol／L]和高出生体重组[（6．4±1．3）mmol／L]（F=3．88，P=0．021）。控制性别、年龄、身长、是否早产、父，母亲糖尿病史、体育锻炼、吸烟、饮酒和随访时间等因素后，与成年期正常BMI者相比，超重肥胖者发生糖代谢异常的0R（95％CI）值为2．73（2．06-3．62）；与成年正常腰围者相比，腹型肥胖者发生糖代谢异常的0R（95％CI）值为3．35（2．49～4．50）。与正常出生体重＋成年期正常BMI相比，正常出生体重＋成年期超重肥胖组的OR（95％CI）值为2．60（1．94～3．49），低出生体重＋成年期超重肥胖的0R（95％C1）值为4．70（1．84—11．99）；低出生体重和成年超重肥胖存在正交互作用，归因比为48．5％。与正常出生体重＋成年期正常腰围相比，正常出�Objective To investigate the joint effect of birth weight and each of obesity measures （body mass index （BMI） and waist circumference （WC）） on abnormal glucose metabolism （including diabetes） at adulthood. Methods Using the historical cohort study design and the convenience sampling method, 1 921 infants who were born in Beijing Union Medical College Hospital from June 1948 to December 1954 were selected to do the follow-up in 1995 and 2001 respectively. Through Beijing Household Registration and Management System, they were invited to participate in this study. A total of 972 subjects （627 were followed up in 1995 and 345 were followed up in 2001） with complete information on genders, age, birth weight, family history of diabetes, BMI, WC, fasting plasma glucose （FPG） and 2-hour plasma glucose （2 h PG） met the study inclusion criteria at the follow-up visits. In the data analysis, they were divided into low, normal, and high birth weight, respectively. The ANOVA and Chi-squared tests were used to compare the differences in their characteristics by birth weight group. In addition, multiple binary Logistic regression model was used to investigate the single effect of birth weight, BMI, and waist circumference on abnormal glucose metabolism at adulthood. Stratification analysis was used to investigate the joint effect of birth weight and each of obesity measures （BMI and WC） on abnormal glucose metabolism. Results There were 972 subjects （males： 50.7%, mean age： （46.0±2.2） years） included in the final data analysis. The 2 h PG in low birth weight group was （7.6±3.2） mmol/L, which was higher than that in normal birth weight group （6.9± 2.1） mmol/L and high birth weight group （6.4±1.3） mmol/L （F=3.88, P=0.021）. After adjustment for genders, age, body length, gestation age, family history of diabetes, physical activity, smoking and alcohol consumption, and duration of follow-up, subjects with overweight and obesity at adulthood had 2.73 （95% confidence

关 键 词：出生体重 糖尿病 糖代谢异常 队列研究 

分 类 号：R589.2[医药卫生—内分泌] R587.1[医药卫生—内科学]