PDF(Pubmed)
Abstract：
To investigate the associations between gestational diabetes mellitus (GDM) metformin or insulin treatment and offspring growth trajectories from 0 to 60 months.
Participants were from the Born in Bradford birth cohort study. Using covariate-adjusted multilevel linear spline models (4 splines: 0-1.6, 1.6-6, 6-17 and 17-60 months), we compared weight, height and body mass index (BMI) z-score trajectories of: (1) 76 offspring exposed to metformin (OGDM-Metformin) and 420 offspring exposed to insulin (OGDM-Insulin); (2) OGDM-Metformin and 9171 offspring not exposed to GDM (No-GDM); (3) OGDM-Insulin and No-GDM.
(1) OGDM-Metformin had comparable growth trajectories to OGDM-Insulin from 0 to 60 months. (2) OGDM-Metformin had a lower mean birthweight z-score than No-GDM. OGDM-Metformin had faster changes in height z-score (0.13 [95% CI 0.026, 0.24]) from 17 to 60 months and by 60 months, had comparable mean BMI z-score to No-GDM. (3) OGDM-insulin had lower mean birthweight and height z-scores than No-GDM. OGDM-Insulin had faster changes in weight (0.32 [0.021, 0.62]) and height (0.50 [0.087, 0.91]) from 1.6 to 6 months and by 60 months, had comparable mean BMI z-score to No-GDM.
GDM metformin treatment was not associated with differences in offspring growth trajectories compared to insulin treatment. Both metformin and insulin-exposed offspring had comparable BMI z-score to No-GDM by 60 months.
Participants were from the Born in Bradford birth cohort study. Using covariate-adjusted multilevel linear spline models (4 splines: 0-1.6, 1.6-6, 6-17 and 17-60 months), we compared weight, height and body mass index (BMI) z-score trajectories of: (1) 76 offspring exposed to metformin (OGDM-Metformin) and 420 offspring exposed to insulin (OGDM-Insulin); (2) OGDM-Metformin and 9171 offspring not exposed to GDM (No-GDM); (3) OGDM-Insulin and No-GDM.
(1) OGDM-Metformin had comparable growth trajectories to OGDM-Insulin from 0 to 60 months. (2) OGDM-Metformin had a lower mean birthweight z-score than No-GDM. OGDM-Metformin had faster changes in height z-score (0.13 [95% CI 0.026, 0.24]) from 17 to 60 months and by 60 months, had comparable mean BMI z-score to No-GDM. (3) OGDM-insulin had lower mean birthweight and height z-scores than No-GDM. OGDM-Insulin had faster changes in weight (0.32 [0.021, 0.62]) and height (0.50 [0.087, 0.91]) from 1.6 to 6 months and by 60 months, had comparable mean BMI z-score to No-GDM.
GDM metformin treatment was not associated with differences in offspring growth trajectories compared to insulin treatment. Both metformin and insulin-exposed offspring had comparable BMI z-score to No-GDM by 60 months.
摘要：
目的：研究妊娠期糖尿病（GDM）二甲双胍或胰岛素治疗与0-60个月子代生长轨迹之间的关系。
方法：参与者来自出生在布拉德福德出生队列研究。使用协变量调整的多级线性样条模型（4条样条：0-1.6、1.6-6、6-17和17-60个月），我们比较了体重,高度,和BMIz得分轨迹：（1）暴露于二甲双胍（OGDM-二甲双胍）的76个后代和暴露于胰岛素（OGDM-胰岛素）的420个后代；（2）OGDM-二甲双胍和未暴露于GDM（No-GDM）的9,171个后代；（3）OGDM-胰岛素和No-GDM。
结果：(1)OGDM-二甲双胍在0-60个月时具有与OGDM-胰岛素相当的生长轨迹。（2）OGDM-二甲双胍的平均出生体重z评分低于非GDM。OGDM-二甲双胍在17-60个月和60个月时的身高z评分变化更快（0.13（95CI0.026,0.24）），与无GDM的平均BMIz评分相当。（3）OGDM-胰岛素的平均出生体重和身高z评分低于No-GDM。OGDM-胰岛素在1.6-6个月和60个月的体重（0.32（0.021，0.62））和身高（0.50（0.087，0.91））变化更快，与无GDM的平均BMIz评分相当。
结论：与胰岛素治疗相比，GDM二甲双胍治疗与后代生长轨迹的差异无关。在60个月时，二甲双胍和胰岛素暴露的后代的BMIz评分与No-GDM相当。
方法：参与者来自出生在布拉德福德出生队列研究。使用协变量调整的多级线性样条模型（4条样条：0-1.6、1.6-6、6-17和17-60个月），我们比较了体重,高度,和BMIz得分轨迹：（1）暴露于二甲双胍（OGDM-二甲双胍）的76个后代和暴露于胰岛素（OGDM-胰岛素）的420个后代；（2）OGDM-二甲双胍和未暴露于GDM（No-GDM）的9,171个后代；（3）OGDM-胰岛素和No-GDM。
结果：(1)OGDM-二甲双胍在0-60个月时具有与OGDM-胰岛素相当的生长轨迹。（2）OGDM-二甲双胍的平均出生体重z评分低于非GDM。OGDM-二甲双胍在17-60个月和60个月时的身高z评分变化更快（0.13（95CI0.026,0.24）），与无GDM的平均BMIz评分相当。（3）OGDM-胰岛素的平均出生体重和身高z评分低于No-GDM。OGDM-胰岛素在1.6-6个月和60个月的体重（0.32（0.021，0.62））和身高（0.50（0.087，0.91））变化更快，与无GDM的平均BMIz评分相当。
结论：与胰岛素治疗相比，GDM二甲双胍治疗与后代生长轨迹的差异无关。在60个月时，二甲双胍和胰岛素暴露的后代的BMIz评分与No-GDM相当。
