在暴露于母体预先存在的1型(T1D)后,在临床队列中检查从出生到10岁的纵向BMI轨迹,类型2(T2D),有或没有抗糖尿病药物治疗的妊娠期糖尿病,怀孕期间没有糖尿病。
数据包括2008-2015年出生的218名227名来自基于人口的综合医疗保健系统的单胎儿童;537名暴露于孕产妇T1D,7836到T2D,6982用于含药GDM,12576用于未含药GDM。通过调整协变量的非线性混合效应模型评估组间BMI随时间的差异。
与无糖尿病组相比,所有糖尿病暴露组的儿童出生后6个月的BMI显著降低。从大约2.5岁开始,T1D的BMI明显较高,T2D和含药GDM组比非糖尿病组。在3岁时,T1D和T2D组中的增长模式开始与最高BMI分离,其次是药物GDM,未用药的GDM,和无糖尿病组。到7岁时,未用药GDM组的BMI明显高于无糖尿病组。调整后的BMI在所有年龄段的T1D和T2D组之间通常具有可比性。从5岁开始,T1D,T2D和药物治疗GDM组的BMI大于无糖尿病组的BMI的一个SD。
在采用标准糖尿病管理方法的临床队列中,在调整了重要的协变量后,在怀孕期间暴露于不同类型糖尿病的后代中存在分层的BMI增长模式,从3岁开始。
To examine longitudinal BMI trajectory from birth to age 10 years in a clinical cohort after exposure to maternal pre-existing type 1 (T1D), type 2 (T2D), gestational diabetes managed with or without anti-diabetes medication, and no diabetes during pregnancy.
Data included 218 227 singleton children born in 2008-2015 from a population-based integrated healthcare system; 537 exposed to maternal T1D, 7836 to T2D, 6982 to medicated GDM and 12 576 to unmedicated GDM. Differences in BMI over time among groups were assessed by non-linear mixed-effects models adjusting for covariates.
Children\'s BMI was significantly lower 6-months after birth for all diabetes exposed groups compared to no diabetes. Beginning at approximately age 2.5 years, BMI was significantly higher for T1D, T2D and medicated GDM groups compared to the no diabetes group. At age 3, the growth pattern started separating with highest BMI in T1D and T2D groups, followed by medicated GDM, unmedicated GDM, and the no diabetes groups. By age 7, BMI was significantly higher for the unmedicated GDM group compared to the no diabetes group. Adjusted BMI was generally comparable between T1D and T2D groups for all ages. Starting at age 5, T1D, T2D and medicated GDM groups had BMI greater than one SD over the BMI in the no diabetes group.
In a clinical cohort with standard diabetes management approaches, a hierarchical BMI growth pattern exists in offspring exposed to different types of diabetes during pregnancy after adjusting for important covariates, starting as early as age 3 years.