母亲肥胖及妊娠期糖尿病增加儿童1型糖尿病风险
创作:Epi汪 审核:Epi汪 2019年05月24日
  • 检索公开发表的数据库,纳入21篇观察性研究;
  • 母亲超重或肥胖的新生儿患1型糖尿病(T1DM)的风险分别是正常体重母亲的1.09、1.25倍;
  • 母亲BMI每增加5kg/m2,儿童T1DM风险增加10%;
  • 母亲低体重与儿童T1DM无统计学关联;
  • 母亲患有T1DM(RR=4.46)、妊娠期糖尿病(RR=1.66),其儿童T1DM的风险增加,而母亲患有2型糖尿病的无上述关联;
  • 父亲患有T1DM,相比母亲患病,与后代的T1DM发病的关联更强;
  • 母亲孕期吸烟者后代T1DM的风险更低。
主编推荐语
Epi汪
1型糖尿病(T1DM)是儿童最常见的慢性疾病之一,原因之一是胰岛素缺乏。本研究通过综述系列观察性研究,发现母亲BMI、妊娠期糖尿病以及父母的糖尿病病史与儿童T1DM患病之间存在关联。该研究提示儿童早期生活事件及环境因素在其患T1DM的风险中发挥着重要的作用。
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Obesity Reviews [IF:7.31]

The influence of maternal body mass index, maternal diabetes mellitus, and maternal smoking during pregnancy on the risk of childhood-onset type 1 diabetes mellitus in the offspring: Systematic review and meta-analysis of observational studies

母亲BMI、妊娠期糖尿病及孕期吸烟对儿童期1型糖尿病的影响:观察性研究的系统综述和荟萃分析

10.1111/obr.12858

2019-05-15, Review

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There is emerging evidence that events occurring before and shortly after birth may be important in determining the risk of childhood-onset type 1 diabetes mellitus (T1DM). We aimed to summarize and synthesize the associations between maternal body mass index (BMI), maternal diabetes mellitus (DM), and maternal smoking during pregnancy and the risk of childhood-onset T1DM in the offspring by performing a systematic review and meta-analysis of observational studies. A random effects model was used to generate the summary risk estimates. The PubMed and Web of Science databases were searched to identify relevant observational studies. Twenty one observational studies were included in the present meta-analysis. Compared with offspring of mothers with normal weight, offspring of women with overweight or obesity were at an increased risk of developing childhood-onset T1DM (overweight: relative risk [RR] 1.09, 95% confidence interval [CI], 1.03-1.15; obesity: RR 1.25, 95% CI, 1.16-1.34; per 5 kg m increase in BMI: RR 1.10, 95% CI, 1.06-1.13). No association was found for maternal underweight (RR 0.92, 95% CI, 0.75-1.13). Maternal DM was associated with an increased risk of childhood-onset T1DM (RR 3.26, 95% CI, 2.84-3.74). Regarding the type of maternal DM, the greatest risk of T1DM in the offspring appeared to be conferred by maternal T1DM (RR 4.46, 95% CI, 2.89-6.89), followed by maternal gestational diabetes mellitus (RR 1.66, 95% CI, 1.16-2.36), and lastly by maternal type 2 diabetes mellitus (RR 1.11, 95% CI, 0.69-1.80). Additional analysis of studies comparing maternal versus paternal T1DM within the same population revealed that offspring of fathers with T1DM had a 1.5 times higher risk of developing childhood-onset T1DM than offspring of mothers with T1DM (RR 9.58, 95% CI, 6.33-14.48 vs. RR 6.24, 95% CI, 5.52-7.07). Furthermore, a reduced risk of childhood-onset T1DM was observed in infants born to mothers who smoked during pregnancy compared with infants born to mothers who did not smoke during pregnancy (RR 0.79, 95% CI, 0.71-0.87). In summary, our findings add further evidence that early-life events or environmental factors may play a role in modulating infants' risk of developing T1DM later in life.

First Authors:
Khemayanto Hidayat

Correspondence Authors:
Bi-Min Shi

All Authors:
Khemayanto Hidayat,Sheng-Yi Zou,Bi-Min Shi

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