出生体重与婴幼儿体格发育及糖脂代谢的相关性分析

Analysis on the correlation of birth weight with physical development and glycolipid metabolism during infancy

目的探讨出生体重(BW)与婴幼儿体格发育及糖脂代谢的相关性,分析婴儿期体格追赶生长的影响因素。方法随机纳入母子配对样本1 064例,收集婴幼儿出生前后的一般情况、0~18月龄体格及喂养数据。检测脐血及18月龄静脉血糖脂代谢指标。结果新生儿BW与血清超敏C反应蛋白(hCRP)显著正相关,与甘油三酯(TG)显著负相关,且仅与女婴脂蛋白a(Lpa)显著正相关(P<0.05)。18月龄时,BW与男童空腹血糖(GLU)及女童高密度脂蛋白胆固醇(HDL-c)显著负相关(P<0.05)。BW与6月龄内体格增长显著负相关,低出生体重(LBW)在6月龄内的体格追赶生长幅度显著较高(P<0.01)。使婴儿6月龄体重指数Z分值(BMIZ)追赶生长加快的因素是BW过低、进食泥状及汁装辅食,使其减慢的因素是父亲高血压、吃奶时间较长、进食鱼虾类频率较高、家庭年收入较高。结论 BW过高或过低均对糖脂代谢产生不利影响。LBW婴儿6月龄内增长幅度显著较高,可能与远期代谢综合征(MS)风险增加有关。

Objective To investigate the correlation of birth weight(BW)with children′s physical development and glycolipid metabolism during infancy,and to analyze the influencing factors of infant catch-up growth.Methods A total of 1 064 mother-child pairs were randomly recruited and the perinatal baseline information,anthropometric indexes and feeding data of children aged 0 to 18 months were recorded.The neonatal cord blood and the venous blood of 18-month-old children were tested for glycolipid metabolism indexes.Results BW of newborns presented significantly positive correlation with serum high sensitivity C-reactive protein(hCRP)but negative correlation with triglyceride(TG),and positive correlation between BW with lipoprotein a(Lpa)was found only in female infants(P<0.05).At 18 months old,negative correlation was found between BW with fasting glucose(GLU)in male and high density lipoprotein cholesterol(HDL-c)in female(P<0.05).Within 6 months old,significantly negative correlation between BW and children′s physical development was detected,and low birth weight(LBW)infants showed significantly more physical catch-up growth(P<0.01).Lower BW,mashed and fluid supplementary food were found to be promoting factors of body mass index Z score(BMIZ)catch-up growth within 6 months old,while paternal hypertension,eating slowly,higher fish-species consumption frequency and higher family income were shown to be weakening factors for BMIZ catch-up growth.Conclusions Extremely high or low of BW is likely to have adverse effects on glycolipid metabolism.Significant higher BMIZ catch-up growth in LBW infants within 6 months old may increase the risk of metabolic syndrome(MS)in adulthood.