Background: Low birth weight (LBW) has been associated with subsequent risks of obesity and certain chronic diseases, but evidence for the associations is limited for the Chinese population.
Methods: In this study we analyzed data from two population-based prospective cohort studies, the Shanghai Women's Health Study and the Shanghai Men's Health Study, to examine the associations between LBW and the risk of obesity and chronic diseases. Birth weight was self-reported at baseline; anthropometric measurements were made at study enrollment. Type 2 diabetes mellitus (T2DM) diagnoses were self-reported, whereas hypertension diagnoses were based on self-report and blood pressure measurements at baseline and follow-up surveys.
Results: Birth weight was available for 11 515 men and 13 569 women. Non-linear associations were observed for birth weight with baseline body mass index (BMI), waist circumference (WC), waist: hip ratio (WHR), and waist: height ratio (WHtR; P < 0.05 for non-linearity), and LBW was linked with lower BMI, smaller WC, and larger WHR and WHtR. An excess risk of T2DM was observed for LBW (<2500 g) versus birth weight 2500-3499 g since baseline (hazard ratio [HR] 1.17; 95% confidence interval [CI] 0.92-1.49) and since birth (HR 1.29; 95% CI 1.07-1.54), whereas the HRs for hypertension since baseline and birth were 1.13 (95% CI 1.01-1.27) and 1.20 (95% CI 1.11-1.30), respectively. The risk of the diseases decreased as birth weight increased up to ~4000 g; further increases in birth weight did not convey additional benefits.
Conclusion: The results suggest that LBW, an index of poor intrauterine nutrition, may affect health risks later in life in the Chinese population.
背景: 低出生体重(Low birth weight,LBW)与成年期肥胖及某些慢性病的风险相关联, 但来源于中国人群的证据有限。
方法: 本研究分析了来自两个以人群为基础的前瞻性队列研究——上海妇女健康研究和上海男子健康研究——的数据, 以检验LBW与肥胖及慢性病风险之间的关联。基线调查时研究对象自报出生体重及2型糖尿病(T2DM)的患病状况, 并接受了身体测量。高血压的诊断则基于自我报告的患病状况以及基线和随访调查时测量的血压值。
结果: 队列成员中共11515名男性和13569名女性具有出生体重信息。出生体重与基线时体重指数(BMI)、腰围(WC)、腰臀比(hip ratio,WHR)和腰高比(waist: height ratio,WHtR)呈非线性关联(非线性检验P < 0.05)。低出生体重与较低的BMI、较小的WC及较高的WHR和WHtR有关。与出生体重为2500‐3499 g的研究对象相比,LBW者(出生体重< 2500 g)基线调查之后以及自出生起患T2DM和高血压的风险均显著升高,T2DM的风险比[HR]和95%置信区间[CI]分别为1.17(0.92‐1.49)和1.29(1.07‐1.54);高血压的HR(95%CI)分别为1.13(1.01‐1.27)和1.20(1.11‐1.30)。随着出生体重增加,T2DM及高血压的发病风险降低, 但达到4000 g后, 出生体重的进一步增加未见额外收益。
结论: LBW作为反映宫内营养不良的指标, 可能影响中国人群成年期健康风险。
Keywords: 2型糖尿病; birth weight; hypertension; obesity; type 2 diabetes; 出生体重; 肥胖; 高血压.
© 2018 The Authors. Journal of Diabetes published by John Wiley & Sons Australia, Ltd and Ruijin Hospital, Shanghai Jiaotong University School of Medicine.