胎儿股骨长度与青少年糖尿病风险:一项前瞻性队列研究。

IF 3.6 Q1 TROPICAL MEDICINE Tropical Medicine and Health Pub Date : 2024-07-01 DOI:10.1186/s41182-024-00611-6
Urme Binte Sayeed, Evana Akhtar, Anjan Kumar Roy, Sharmin Akter, Ondine S von Ehrenstein, Rubhana Raqib, Yukiko Wagatsuma
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引用次数: 0

摘要

背景:糖尿病在成年期更为明显,但在儿童期可能处于休眠状态,并起源于胎儿的早期发育。在胎儿生物测量中,股骨长度(FL)对评估胎儿的生长发育至关重要。本研究旨在评估孟加拉国儿童胎儿股骨生长与糖尿病前期生物标志物之间的潜在关联:方法:在孟加拉国的马特拉布(Matlab)进行了一项队列研究,其中包含一项基于人群的孕产妇食物和微量营养素补充试验(MINIMat)。对队列中的儿童进行了跟踪调查,直至他们 15 岁。在最初的试验中,怀孕是在 13 孕周(GWs)之前通过超声波确认的。之后,分别在 14、19 和 30 孕周进行超声波评估。FL的测量是从一端到另一端,采集完整的股骨图像。FL按GW标准化,并计算出z分数。测定血浆和全血中的 FBG 和 HbA1c 水平,并计算甘油三酯-葡萄糖指数(胰岛素抵抗的生物标志物),即 Ln [空腹甘油三酯(毫克/分升)×空腹葡萄糖(毫克/分升)/2]。使用广义线性模型进行多变量线性回归分析,以估计 FL 在 14、19 和 30 GWs 时对 9 岁和 15 岁糖尿病前期生物标志物的影响。母亲微量营养素和食物补充组别、胎次、儿童性别以及9岁或15岁时的体重指数均被列为协变量:结果:在青春期前,共有 1.2%(6/515)的参与者空腹血糖受损,在青春期则增至 3.5%(15/433)。9 岁时,6.3%(32/508)的参与者 HbA1c% 升高,15 岁时升至 28%(120/431)。此外,TyG 指数从 9.5%(49/515)(青春期前)上升到 13%(56/433)(青春期)。14 和 19 岁时 FL 下降一个标准差与 FBG 增加有关(β = - 0.44 [- 0.88, - 0.004],P = 0.048;β = - 0.59 [- 1.12,- 0.05],P = 0.031)和 15 岁时的 HbA1c(β = - 0.01;[- 0.03,- 0.005],P = 0.007;β = - 0.01 [- 0.03,- 0.003],P = 0.018)水平。FL与9岁时的糖尿病生物标志物无关:结论:妊娠中期股骨发育受损可能与孟加拉国青少年糖尿病前期生物标志物升高有关。
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Fetal femur length and risk of diabetes in adolescence: a prospective cohort study.

Background: Diabetes is more apparent in adulthood but may be dormant in childhood and originates during early fetal development. In fetal biometry, femur length (FL) is crucial for assessing fetal growth and development. This study aimed to assess potential associations between fetal femur growth and prediabetic biomarkers in Bangladeshi children.

Methods: A cohort study embedded in a population-based maternal food and micronutrient supplementation (MINIMat) trial was conducted in Matlab, Bangladesh. The children in the cohort were followed up until 15 years of age. In the original trial, pregnancy was confirmed by ultrasound before 13 gestational weeks (GWs). Afterward, ultrasound assessments were performed at 14, 19, and 30 GWs. FL was measured from one end to the other, capturing a complete femoral image. The FL was standardized by GW, and a z-score was calculated. FBG and HbA1c levels were determined in plasma and whole blood, and the triglyceride-glucose index, a biomarker of insulin resistance, was calculated as Ln [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Multivariable linear regression analysis using a generalized linear model was performed to estimate the effects of FL at 14, 19 and 30 GWs on prediabetic biomarkers at 9 and 15 years of age. Maternal micronutrient and food supplementation group, parity, child sex, and BMI at 9 years or 15 years were included as covariates.

Results: A total of 1.2% (6/515) of the participants had impaired fasting glucose during preadolescence, which increased to 3.5% (15/433) during adolescence. At 9 years, 6.3% (32/508) of the participants had elevated HbA1c%, which increased to 28% (120/431) at 15 years. Additionally, the TyG index increased from 9.5% (49/515) (during preadolescence) to 13% (56/433) (during adolescence). A one standard deviation decrease in FL at 14 and 19 GWs was associated with increased FBG (β = - 0.44 [- 0.88, - 0.004], P = 0.048; β = - 0.59 [- 1.12, - 0.05], P = 0.031) and HbA1c (β = - 0.01; [- 0.03, -0.005], P = 0.007; β = - 0.01 [- 0.03, - 0.003], P = 0.018) levels at 15 years. FL was not associated with diabetic biomarkers at 9 years.

Conclusion: Mid-trimester impaired femur growth may be associated with elevated prediabetic biomarkers in Bangladeshi adolescents.

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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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