孕期营养、出生体重与后期代谢综合征患病率的相关性研究

Pregnancy nutrition, birth weight and the development of metabolic syndrome

目的 比较不同时期出生的新生儿的体重与后期代谢综合征（MS）的患病率,探讨困难时期出生体重与代谢综合征患病率的关系.方法 分别于2008年8月和2012年10月在山西省晋中市开展了针对同一人群的两次队列研究,选取1956、1960、1964年出生的561名受试者为研究对象.对受检人员进行问卷调查、体格检查及血液生化检验,记录身高,体重,腰围,血糖,三酰甘油,血压等数据,对受检人员的母亲进行了电话回忆问卷调查,调查母亲孕期营养情况及婴儿出生体重,通过SPSS 17.0统计软件分析孕期营养、出生体重与后期代谢综合征患病率的关系.结果 最终符合条件的受检人员为100名,其中男性42名,女性58名.2008年符合MS诊断标准的有39名,2012年符合MS诊断标准的有41名.1964、1960、1956年出生的人群间MS患病率的差异有统计学意义（2008年：x2 =6.41,P＜0.05,2012年：x2=8.14,P＜0.05）.1960年出生的婴儿平均体重为（2.9±0.6） kg,较1964年的（3.2±0.4） kg,1956年的（3.3±0.5） kg明显偏低,差异有统计学意义（t=5.88、6.32,P＜0.05）.100名母亲的孕期营养状况统计显示1960年孕期营养状况不良（68.9％）明显高于1956年（28.6％）和1964年（45.2％）,差异有统计学意义（x2=14.15、4.39,P＜0.05）.出生体重与后期MS的Pearson相关系数为-0.106,孕期营养与后期MS的Pearson相关系数为-0.005.结论 孕期营养不良,成年后发生代谢综合征的概率较高,及早开展母孕期营养不良人群的健康管理工作至关重要.

Objective To explore the relationship between birth weight and the prevalence of metabolic syndrome （MS）.Methods A population cohort study was carried out among 561 adults who were born in 1956,1960 or 1964 in Jinzhong City of Shanxi Province in August 2008 and October 2012.All the participants were required to fill in a questionnaire survey,take physical examinations and laboratory tests.Height,body weight,waist circumference,blood glucose,triglyceride and blood pressure were recorded.Their mothers were interviewed through phone call.Results One hundred individuals were finally qualified,including 42 men and 58 women.Thirty-nine and 41 MS patients were detected in 2008 and 2012,respectively.Prevalence of MS showed statistically significant difference among those born in 1964,1960 or 1956（2008：x2 =6.41,P ＜ 0.05; 2012：x2 =8.14,P ＜ 0.05）.The average body weight of babies born in 1960 （（2.9 ± 0.6） kg） was significantly lower than those born in 1964 （（3.2 ±0.4） kg） or 1956 （（3.3 ±0.5） kg） （t values were 5.88 and 6.32,respectively; both P ＜0.05）.The rate of poor nutrition during pregnancy was significantly higher in 1960 （68.9％） than in 1956 （28.6％） and 1964 （45.2％） （x2 values were 14.15 and 4.39,respectively; both P ＜ 0.05）.In Pearson correlation analysis,coefficient of birth weight and post-MS was-0.106,the coefficient of nutrition during pregnancy and post-MS was -0.005.Conclusions The non-low birth weight children whose mothers had pregnancy malnutrition show higher prevalence of MS in adult.It could be important to carry out health management among children whose mother has experienced pregnancy malnutrition.