Background： Fetal insulin hypothesis was proposed that the association between low birth weight and type 2 diabetes is principally genetically mediated. The aim of this study was to investigate whether common variant...Background： Fetal insulin hypothesis was proposed that the association between low birth weight and type 2 diabetes is principally genetically mediated. The aim of this study was to investigate whether common variants in genes CDKALI, HHEX, ADCY5, SRR, PTPRD that predisposed to type 2 diabetes were also associated with reduced birthweight in Chinese Han population.Methods： Twelve single nucleotide polymorphisms （rs7756992/rs10946398 in CDKAL1, rsl 111875 in HHEA; rs391300 in SRR, rs17584499 in PTPRD. rs1170806/rs9883204/rs4678017/rs9881942/rs7641344/rs6777397/rs6226243 in ADCY5） were genotyped in 1174 unrelated individuals born in Peking Union Medical College Hospital from 1921 to 1954 by TaqMan allelic discrimination assays, of which 645 had normal glucose tolerance, 181 had developed type 2 diabetes and 348 impaired glucose regulation. Associations of these 12 genetic variants with birthweight and glucose metabolism in later life were analyzed.Results： Birthweight was inversely associated with CDKAL 1-rs 10946398 （β = -41 g [95% confidence interval [CI]： -80, 3], P= 0.034）, common variants both associated with increased risk of impaired glucose metabolism and decreased insulin secretion index later in life. After adjusting for sex, gestational weeks, parity and maternal age, the risk allele of CDKAL1-rs7756992 was associated with reduced birthweight （β = 36 g [95% CI： -72, -0.2], P = 0.048）. The risk allele in SRR showed a trend toward a reduction ofbirthweight （P =0.085）. Conclusions： This study identified the association between type 2 diabetes risk variants in CDKAL 1 and birthweight in Chinese Hart individuals, and the carrier of risk allele within SRR had the trend of reduced birthweight. This demonstrates that there is a clear overlap between the genetics of type 2 diabetes and fetal growth, which proposes that lower birth weight and type 2 diabetes may be two phenotypes of one genotype.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Different gestational </span><span style=&q...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Different gestational </span><span style="font-family:Verdana;">age specific</span> <span style="font-family:Verdana;">birthweight</span><span style="font-family:Verdana;"> reference charts have been produced for different populations and ethnic groups over different </span><span style="font-family:Verdana;">time periods</span><span style="font-family:Verdana;">, mostly based on birthweight data. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of </span><a name="_Hlk11503682"></a><span style="font-family:Verdana;">small and large for gestational age (SGA and LGA) fetuses, and to verify whether there are significant differences compared to previously published local reference charts, as well as to other southern Chinese </span><span style="font-family:Verdana;">and international</span><span style="font-family:Verdana;"> data. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> All singleton Chinese livebirths deliv</span><span style="font-family:Verdana;">ered in United Christian Hospital from 2012 to 2017 were retrospectively included. The smoothed birthweight centiles at each gestation were computed. The birthweight centiles were then compared with other reference charts.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> A total of 25,508 </span><span style="font-family:Verdana;">livebirths</span><span style="font-family:Verdana;"> between 24 and 42 completed weeks of gestation were enrolled in the final analysis. The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ra展开更多
目的探讨双胎新生儿出生体重差值(ΔBW)预测双胎新生儿之一发生并发症的临床意义。方法选择2018年1月至2019年12月,在南京大学医学院附属鼓楼医院分娩的752对(1504例)活产双胎新生儿,及其母亲为研究对象。根据双胎新生儿是否发生并发症...目的探讨双胎新生儿出生体重差值(ΔBW)预测双胎新生儿之一发生并发症的临床意义。方法选择2018年1月至2019年12月,在南京大学医学院附属鼓楼医院分娩的752对(1504例)活产双胎新生儿,及其母亲为研究对象。根据双胎新生儿是否发生并发症(双胎新生儿之一或双胎新生儿均发生并发症),将其分别纳入研究组(n=178)和对照组(n=574);再根据研究组双胎新生儿是否被转入新生儿重症监护病房(NICU),进一步分为NICU亚组(n=153)和非NICU亚组(n=25)。影响双胎新生儿之一发生并发症因素进行单因素分析和多因素非条件logistics回归分析,并绘制预测双胎新生儿之一总体并发症的受试者工作特征(ROC)曲线。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求,并经南京大学医学院附属鼓楼医院伦理委员会审核批准(批准文号:2020-264)。结果①752对双胎中,178对双胎新生儿之一发生并发症,发生率为23.7%(178/752)。②研究组双胎的剖宫产术分娩率、辅助生殖率、出生胎龄与体重及Apgar评分均低于对照组,而研究组产妇妊娠期高血压疾病(HDCP)、单绒毛膜(MC)双胎妊娠、双胎之一出生体重<P10或<P3所占比例、ΔBW及转入NICU率,均显著高于对照组,并且差异均有统计学意义(P<0.05)。③NICU亚组双胎出生胎龄及体重、生后1和5 min Apgar评分,均低于非NICU亚组,并且差异均有统计学意义(P<0.05)。④多因素非条件logistics回归分析结果显示,剖宫产分娩(OR=0.246,95%CI:0.145~0.418,P<0.001)、胎龄<37周(OR=22.294,95%CI:10.884~45.666,P<0.001),双胎之一脐血流异常(OR=2.879,95%CI:1.183~7.004,P=0.020),双胎之一出生体重<P3(OR=3.384,95%CI:1.598~7.164,P=0.001),均是双胎新生儿之一发生并发症的独立影响因素。对ΔBW分层分析结果显示,20%≤ΔBW<30%(OR=4.799,95%CI:2.612~8.814,P<0.001)与ΔBW≥30%(OR=15.984,95%CI:4.369~58.475,P<0.001),亦是双胎新生儿之一�展开更多
基金Source of Support： This study was supported by grants from the Natural Sciences Foundation of Beijing （No. 5072042）, National Natural Science Foundation of China （No. 81170736）, National Key Program of Clinical Science. Conflict of Interest： None declared.
文摘Background： Fetal insulin hypothesis was proposed that the association between low birth weight and type 2 diabetes is principally genetically mediated. The aim of this study was to investigate whether common variants in genes CDKALI, HHEX, ADCY5, SRR, PTPRD that predisposed to type 2 diabetes were also associated with reduced birthweight in Chinese Han population.Methods： Twelve single nucleotide polymorphisms （rs7756992/rs10946398 in CDKAL1, rsl 111875 in HHEA; rs391300 in SRR, rs17584499 in PTPRD. rs1170806/rs9883204/rs4678017/rs9881942/rs7641344/rs6777397/rs6226243 in ADCY5） were genotyped in 1174 unrelated individuals born in Peking Union Medical College Hospital from 1921 to 1954 by TaqMan allelic discrimination assays, of which 645 had normal glucose tolerance, 181 had developed type 2 diabetes and 348 impaired glucose regulation. Associations of these 12 genetic variants with birthweight and glucose metabolism in later life were analyzed.Results： Birthweight was inversely associated with CDKAL 1-rs 10946398 （β = -41 g [95% confidence interval [CI]： -80, 3], P= 0.034）, common variants both associated with increased risk of impaired glucose metabolism and decreased insulin secretion index later in life. After adjusting for sex, gestational weeks, parity and maternal age, the risk allele of CDKAL1-rs7756992 was associated with reduced birthweight （β = 36 g [95% CI： -72, -0.2], P = 0.048）. The risk allele in SRR showed a trend toward a reduction ofbirthweight （P =0.085）. Conclusions： This study identified the association between type 2 diabetes risk variants in CDKAL 1 and birthweight in Chinese Hart individuals, and the carrier of risk allele within SRR had the trend of reduced birthweight. This demonstrates that there is a clear overlap between the genetics of type 2 diabetes and fetal growth, which proposes that lower birth weight and type 2 diabetes may be two phenotypes of one genotype.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Different gestational </span><span style="font-family:Verdana;">age specific</span> <span style="font-family:Verdana;">birthweight</span><span style="font-family:Verdana;"> reference charts have been produced for different populations and ethnic groups over different </span><span style="font-family:Verdana;">time periods</span><span style="font-family:Verdana;">, mostly based on birthweight data. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of </span><a name="_Hlk11503682"></a><span style="font-family:Verdana;">small and large for gestational age (SGA and LGA) fetuses, and to verify whether there are significant differences compared to previously published local reference charts, as well as to other southern Chinese </span><span style="font-family:Verdana;">and international</span><span style="font-family:Verdana;"> data. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> All singleton Chinese livebirths deliv</span><span style="font-family:Verdana;">ered in United Christian Hospital from 2012 to 2017 were retrospectively included. The smoothed birthweight centiles at each gestation were computed. The birthweight centiles were then compared with other reference charts.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> A total of 25,508 </span><span style="font-family:Verdana;">livebirths</span><span style="font-family:Verdana;"> between 24 and 42 completed weeks of gestation were enrolled in the final analysis. The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ra
文摘目的探讨双胎新生儿出生体重差值(ΔBW)预测双胎新生儿之一发生并发症的临床意义。方法选择2018年1月至2019年12月,在南京大学医学院附属鼓楼医院分娩的752对(1504例)活产双胎新生儿,及其母亲为研究对象。根据双胎新生儿是否发生并发症(双胎新生儿之一或双胎新生儿均发生并发症),将其分别纳入研究组(n=178)和对照组(n=574);再根据研究组双胎新生儿是否被转入新生儿重症监护病房(NICU),进一步分为NICU亚组(n=153)和非NICU亚组(n=25)。影响双胎新生儿之一发生并发症因素进行单因素分析和多因素非条件logistics回归分析,并绘制预测双胎新生儿之一总体并发症的受试者工作特征(ROC)曲线。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求,并经南京大学医学院附属鼓楼医院伦理委员会审核批准(批准文号:2020-264)。结果①752对双胎中,178对双胎新生儿之一发生并发症,发生率为23.7%(178/752)。②研究组双胎的剖宫产术分娩率、辅助生殖率、出生胎龄与体重及Apgar评分均低于对照组,而研究组产妇妊娠期高血压疾病(HDCP)、单绒毛膜(MC)双胎妊娠、双胎之一出生体重<P10或<P3所占比例、ΔBW及转入NICU率,均显著高于对照组,并且差异均有统计学意义(P<0.05)。③NICU亚组双胎出生胎龄及体重、生后1和5 min Apgar评分,均低于非NICU亚组,并且差异均有统计学意义(P<0.05)。④多因素非条件logistics回归分析结果显示,剖宫产分娩(OR=0.246,95%CI:0.145~0.418,P<0.001)、胎龄<37周(OR=22.294,95%CI:10.884~45.666,P<0.001),双胎之一脐血流异常(OR=2.879,95%CI:1.183~7.004,P=0.020),双胎之一出生体重<P3(OR=3.384,95%CI:1.598~7.164,P=0.001),均是双胎新生儿之一发生并发症的独立影响因素。对ΔBW分层分析结果显示,20%≤ΔBW<30%(OR=4.799,95%CI:2.612~8.814,P<0.001)与ΔBW≥30%(OR=15.984,95%CI:4.369~58.475,P<0.001),亦是双胎新生儿之一�
