胎儿期暴露于母体肥胖和妊娠期糖尿病的儿童存在瘦素抵抗。
Leptin resistance in children with in utero exposure to maternal obesity and gestational diabetes.
机构信息
Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, Alabama, USA.
出版信息
Pediatr Obes. 2023 Dec;18(12):e13081. doi: 10.1111/ijpo.13081. Epub 2023 Oct 20.
BACKGROUND
Leptin resistance occurs with obesity, but it is unknown if individuals at risk for obesity develop leptin resistance prior to obesity.
OBJECTIVE
Investigate whether leptin resistance is independent of weight status in children at risk for obesity due to intrauterine exposure to maternal obesity or gestational diabetes mellitus (GDM).
METHODS
Mother-child dyads (N = 179) were grouped by maternal pregnancy weight and GDM status: (1) normal weight, no GDM; (2) overweight/obesity, no GDM; (3) overweight/obesity with GDM. Children (4-10 years) were further stratified by current body mass index (BMI) <85th or ≥85th percentile. Leptin resistance of children and mothers was calculated as fasting leptin/fat mass index. Two-way ANOVA was used to assess whether leptin concentrations and leptin resistance differed by current weight status or in utero exposure group, after adjusting for race, sex and Tanner stage.
RESULTS
Children with a BMI ≥85th percentile had more leptin resistance than those with a BMI <85th percentile (p < 0.001), but leptin resistance did not differ by in utero exposure. Similarly, leptin resistance in women was associated with weight status and not prior GDM.
CONCLUSIONS
Results suggest that leptin concentrations are associated with obesity but not risk for obesity based on in utero exposure to maternal obesity or GDM.
背景
肥胖会导致瘦素抵抗，但尚不清楚肥胖风险人群是否会在肥胖之前就出现瘦素抵抗。
目的
研究由于宫内暴露于母体肥胖或妊娠糖尿病（GDM）而肥胖风险增加的儿童中，瘦素抵抗是否独立于体重状态。
方法
根据母亲妊娠体重和 GDM 状态将母婴对子（N=179）分为以下三组：（1）正常体重，无 GDM；（2）超重/肥胖，无 GDM；（3）超重/肥胖伴 GDM。根据当前 BMI（<85 百分位或≥85 百分位）将儿童（4-10 岁）进一步分层。计算儿童和母亲的瘦素抵抗指数为空腹瘦素/脂肪质量指数。采用双因素方差分析来评估在调整种族、性别和性发育阶段后，当前体重状态或宫内暴露组是否会影响瘦素浓度和瘦素抵抗。
结果
BMI≥85 百分位的儿童比 BMI<85 百分位的儿童有更高的瘦素抵抗（p<0.001），但宫内暴露组之间的瘦素抵抗没有差异。同样，女性的瘦素抵抗与体重状态有关，而与之前的 GDM 无关。
结论
结果表明，瘦素浓度与肥胖有关，但与基于宫内暴露于母体肥胖或 GDM 的肥胖风险无关。
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