不同出生体重个体早期生长对儿童期体脂和胰岛素敏感性的影响
불동출생체중개체조기생장대인동기체지화이도소민감성적영향
The effect of birth weight and early growth on body fat composition and insulin sensitivity
  • 万方数据
    中华预防医学杂志 중화예방의학잡지
    CHINESE JOURNAL OF
    2011年 7期 633-638 ,共6页

    余慕雪%丘小汕%冯素娥%莫清萍%谢笑英%沈振宇%刘泳洲

    여모설%구소산%풍소아%막청평%사소영%침진우%류영주

    出生体重%体脂肪率%胰岛素%评价研究 齣生體重%體脂肪率%胰島素%評價研究
    출생체중%체지방솔%이도소%평개연구
    Birth weight%Adiposity%Insulin%Evaluation studies
    目的 分析不同出生体重个体早期生长对儿童期体脂成分和胰岛素敏感性的影响.方法 2009年6月至2010年2月收集258名广州市年龄6～7岁儿童的出生和生长发育资料,进行体格和实验室检查,包括体重、身高和体脂成分指标[包括体质指数(BMI)、体脂百比分(PBF)、腰围身高比(WtHR)等];测定空腹血糖和胰岛素,计算胰岛素抵抗指数(HOMA-IR).按照出生体重三分位从低到高分为BW-Ⅰ、BW-Ⅱ、BW-Ⅲ组;按0～36个月体重标准差评分(SDS)增长程度分为增长改变(CU)、无改变(NC)、下降改变(CD)组.分析不同出生体重个体及早期生长状况对儿童期体脂成分和胰岛素敏感性的影响.结果 BW-Ⅰ组0～36个月体重SDS增长值为(1.06±1.29),高于BW-Ⅱ组(-0.19±0.94)和BW-Ⅲ组(-0.10±1.20)(P值均<0.01).CU组的出生体重为(2.90±0.47)kg,低于NC组的(3.22±0.34)kg和CD组的(3.57±0.37)kg(P值均<0.01).BW-Ⅲ组BMI、PBF、WtHR分别为(16.35±2.13)kg/m2、(17.03±5.88)%、(0.479±0.033),高于BW-Ⅰ组的(15.46±2.06)kg/m2、(14.06±5.25)%、(0.459±0.032)和BW-Ⅱ组的(15.47±1.58)kg/m2、(14.09±5.01)%、(0.460±0.025)(P值均<0.01),而BW-Ⅰ组与BW-Ⅱ组差异无统计学意义(P>0.05).CU组BMI、PBF、WtHR 分别为(16.44±2.20)kg/m2、(16.51±5.78)%、(0.473±0.034),高于NC组的(15.62±1.74)kg/m2、(14.49±5.30)%、(0.463±0.030)和CD组的(15.26±1.85)kg/m2、(14.24±5.54)%、(0.462±0.031)(P值均<0.05).CU组中,BW-Ⅲ-CU组BMI、PBF、WtHR分别为(18.76±2.56)kg/m2、(22.19±8.28)%、(0.512±0.029),高于BW-Ⅰ-CU组的(16.04±2.14)kg/m2、(15.54±5.28)%、(0.467±0.034)和BW-Ⅱ-CU组的(16.70±1.36)kg/m2、(17.12±4.44)%、(0.474±0.017)(P值均<0.05),而BW-Ⅰ-CU组与BW-Ⅱ-CU组差异无统计学意义(P>0.05).CU组HOMA-IR为(1.27±0.44),高于NC组的(1.08±0.31)和CD组的(1.00±0.36)(P值均<0.01).CU组中,BW-Ⅲ-CU组HOMA-IR为(1.69±0.48),高于BW-Ⅰ-CU组的(1.21±0.41)和BW-Ⅱ-CU组的(1.27±0.44)(P值均<0.01),而BW-Ⅰ-CU组与BW-Ⅱ-CU组差异无统计学意义(P>0.05).结论 以出生体重三分位法分组,较低出生体重且生后早期体重增长程度高的个体,以及较高出生体重个体在儿童期的体脂成分均较高,是胰岛素抵抗发生的高危人群.
    목적 분석불동출생체중개체조기생장대인동기체지성분화이도소민감성적영향.방법 2009년6월지2010년2월수집258명엄주시년령6～7세인동적출생화생장발육자료,진행체격화실험실검사,포괄체중、신고화체지성분지표[포괄체질지수(BMI)、체지백비분(PBF)、요위신고비(WtHR)등];측정공복혈당화이도소,계산이도소저항지수(HOMA-IR).안조출생체중삼분위종저도고분위BW-Ⅰ、BW-Ⅱ、BW-Ⅲ조;안0～36개월체중표준차평분(SDS)증장정도분위증장개변(CU)、무개변(NC)、하강개변(CD)조.분석불동출생체중개체급조기생장상황대인동기체지성분화이도소민감성적영향.결과 BW-Ⅰ조0～36개월체중SDS증장치위(1.06±1.29),고우BW-Ⅱ조(-0.19±0.94)화BW-Ⅲ조(-0.10±1.20)(P치균<0.01).CU조적출생체중위(2.90±0.47)kg,저우NC조적(3.22±0.34)kg화CD조적(3.57±0.37)kg(P치균<0.01).BW-Ⅲ조BMI、PBF、WtHR분별위(16.35±2.13)kg/m2、(17.03±5.88)%、(0.479±0.033),고우BW-Ⅰ조적(15.46±2.06)kg/m2、(14.06±5.25)%、(0.459±0.032)화BW-Ⅱ조적(15.47±1.58)kg/m2、(14.09±5.01)%、(0.460±0.025)(P치균<0.01),이BW-Ⅰ조여BW-Ⅱ조차이무통계학의의(P>0.05).CU조BMI、PBF、WtHR 분별위(16.44±2.20)kg/m2、(16.51±5.78)%、(0.473±0.034),고우NC조적(15.62±1.74)kg/m2、(14.49±5.30)%、(0.463±0.030)화CD조적(15.26±1.85)kg/m2、(14.24±5.54)%、(0.462±0.031)(P치균<0.05).CU조중,BW-Ⅲ-CU조BMI、PBF、WtHR분별위(18.76±2.56)kg/m2、(22.19±8.28)%、(0.512±0.029),고우BW-Ⅰ-CU조적(16.04±2.14)kg/m2、(15.54±5.28)%、(0.467±0.034)화BW-Ⅱ-CU조적(16.70±1.36)kg/m2、(17.12±4.44)%、(0.474±0.017)(P치균<0.05),이BW-Ⅰ-CU조여BW-Ⅱ-CU조차이무통계학의의(P>0.05).CU조HOMA-IR위(1.27±0.44),고우NC조적(1.08±0.31)화CD조적(1.00±0.36)(P치균<0.01).CU조중,BW-Ⅲ-CU조HOMA-IR위(1.69±0.48),고우BW-Ⅰ-CU조적(1.21±0.41)화BW-Ⅱ-CU조적(1.27±0.44)(P치균<0.01),이BW-Ⅰ-CU조여BW-Ⅱ-CU조차이무통계학의의(P>0.05).결론 이출생체중삼분위법분조,교저출생체중차생후조기체중증장정도고적개체,이급교고출생체중개체재인동기적체지성분균교고,시이도소저항발생적고위인군.
    Objective To investigate the effect of birth weight and early growth on body fat composition and insulin sensitivity.Methods The birth and growth data of 258 children of 6 to 7 years old in Guangzhou were collected from Jun.2009 to Feb.2010.Physical and laboratory examination were preformed,which included body weight,body height and body fat composition index (body mass index (BMI),percentage of body fat (PBF),waist circumference to height ratio (WtHR),etc).Fasting blood glucose and insulin were measured.The homeostasis model assessment model for insulin resistance index (HOMA-IR) was calculated.According to birth weight,the children were divided into three groups from light to heavy: BW-Ⅰ,BW-Ⅱ,BW-Ⅲ group.Then according to change in weight SDS between 0 and 36 months,the children were divided into three groups: changers up (CU),non-changers (NC),changers down (CD) group.The effect of birth weight and early growth on body fat composition and insulin sensitivity were analyzed.Results Change in weight SDS between 0 and 36 months was higher in BW-Ⅰgroup (1.06±1.29) than in the BW-Ⅱgroup (-0.19±0.94) and BW-Ⅲ group (-0.10±1.20) (all P values<0.01).Birth weight of the CU group ((2.90±0.47)kg) was lower than that of the NC group ((3.22±0.34)kg) and the CD group ((3.57±0.37)kg) (all P values<0.01).The body fat composition index of BMI,PBF and WtHR were higher in the BW-Ⅲ group ((16.35±2.13)kg/m2,(17.03±5.88)%,(0.479±0.033)) than in the BW-Ⅰ group ((15.46±2.06)kg/m2,(14.06±5.25)%,(0.459±0.032)) and BW-Ⅱ group ((15.47±1.58)kg/m2,(14.09±5.01)%,(0.460±0.025)) (P<0.01),while there was no significant difference between the BW-Ⅰ group and the BW-Ⅱ group (P>0.05).The body fat composition index of BMI,PBF and WtHR were higher in the CU group ((16.44±2.20)kg/m2,(16.51±5.78)%,(0.473±0.034) ) than in the NC group ((15.62±1.74)kg/m2,(14.49±5.30)%,(0.463±0.030) ) and the CD group ((15.26±1.85)kg/m2,(14.24±5.54)%,(0.462±0.031)) (all P values<0.05).In the CU group,BMI,PBF and WtHR were higher in the BW-Ⅲ-CU group ((18.76±2.56)kg/m2,(22.19±8.28)%,(0.512±0.029)) than in the BW-Ⅰ-CU group ((16.04±2.14)kg/m2,(15.54±5.28)%,(0.467±0.034)) and BW-Ⅱ-CU group ((16.70±1.36)kg/m2,(17.12±4.44)%,(0.474±0.017)) (all P values <0.05),while there was no significant difference between the BW-Ⅰ-CU group and the BW-Ⅱ-CU group (P>0.05).HOMA-IR was higher in the CU group ( 1.27±0.44) than in the NC group (1.08±0.31) and the CD group (1.00±0.36) (all P values<0.01).In the CU group,HOMA-IR was higher in the BW-Ⅲ-CU group (1.69±0.48) than in the BW-Ⅰ-CU group (1.21±0.41) and the BW-Ⅱ-CU group (1.27±0.44) (all P values<0.01),while there was no significant difference between the BW-Ⅰ-CU and BW-Ⅱ-CU group (P>0.05).Conclusion According to birth weight tertile,both lower birth weight individuals with more weight change-up growth postnatal early and higher birth weight individuals had greater body fat composition in childhood.They were high-risk people of insulin resistance.
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