胎児の早産と,出生時および幼児期における血インスリン濃度のランダム化
Guoying Wang1, Sara Divall2, Sally Radovick2
1Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
JAMA
|February 13, 2014
まとめ
胎児の早産は,出生時および幼児期のインスリン濃度の上昇と関連しており,長期的な代謝的健康リスクの可能性を示唆しています. 低妊娠年齢とインスリン値上昇の間のこの関連は,インスリン抵抗性および2型糖尿病の発症への影響をさらに調査する必要があります.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 新生児の健康について
- メタボリック障害 メタボリック障害
背景:
- 以前の研究では,早産と後のインスリン抵抗性との関連が示されています.
- しかし,インスリンホメオスタシスの変化が出生時に検出され,子供時代を通して持続するかどうかは不明である.
研究 の 目的:
- 胎児の早産が,出産時の血インスリン濃度の上昇と関連しているかどうかを判断する.
- この関連が幼少期まで続くかどうかを調査する.
主な方法:
- プロスペクティブな出生コホート研究では,1358人の子どもが参加しました.
- 血インスリン濃度は,出生 (帯血) と幼児期 (平均年齢1.4歳) に測定されました.
- 参加者は4つの妊娠年齢グループに分けられた:満期 (≥39 wk),早期 (37-38 wk),遅い早産 (34-36 wk),および早期早産 (<34 wk).
主要な成果:
- インスリン濃度の上昇は,出生時に,そして妊娠年齢の低下とともに幼児期に観察されました.
- 具体的には,早産児 (<34週間) は,出産時のインスリン濃度 (2.05倍),幼児期 (1.31倍) が,満期児と比較して有意に高かった.
- 関連性は,産後体重増加を調整した後に弱まり,出生インスリンレベルを調整した後に有意ではなかった. 出生時にトップ・インスリン・テルチルに入っていた乳児は,子供の頃にトップ・テルチルに留まる可能性が高くなった.
結論:
- 妊娠年齢と出生時および幼児期の血インスリン濃度の上昇との間には,逆の関連性がある.
- これらの発見は,早産が出生からインスリンホメオスタシスの変化の危険因子である可能性があることを示唆しています.
- 将来のインスリン抵抗性および2型糖尿病の発症への影響を調べるためにさらなる研究が必要です.
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