journal1 ›› 2018, Vol. 26 ›› Issue (5): 488-491.DOI: 10.11852/zgetbjzz2018-26-05-07

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Association of maternal sleep in late pregnancy with insulin level and insulin resistance in offsprings at the age of 2 years old

ZHU Li-xia1,2, WANG Guang-hai1,2, JIANG Yan-rui1,2, LIN Qing-min1,2, DENG Yu-jiao1,2, JIANG Fan1,2   

  1. 1 Department of Developmental and Behavioral Pediatrics, Shanghai Children′s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;
    2 MOE-Shanghai Key Laboratory of Children′s Environmental Health, Shanghai 200092, China
  • Received:2017-02-05 Online:2018-05-10 Published:2018-05-10
  • Contact: JIANG Fan, E-mail: fanjiang@ shsmu.edu.cn

孕晚期母亲睡眠与子代2岁胰岛素和胰岛素抵抗的相关性研究

朱丽霞1,2, 王广海1,2, 姜艳蕊1,2, 林青敏1,2, 邓玉娇1,2, 江帆1,2   

  1. 1 上海交通大学医学院附属上海儿童医学中心发育行为儿科,转化医学研究所发育行为研究室,上海 200127
    2 教育部和上海市环境与儿童健康重点实验室,上海 200092
  • 通讯作者: 江帆,E-mail:fanjiang@ shsmu. edu. cn
  • 作者简介:朱丽霞(1989-),女,江苏人,硕士研究生在读,主要研究方向为睡眠与肥胖。
  • 基金资助:
    国家自然科学基金(81422040,81773443);科技部重点专项(2016YFC1305203);上海市科委优秀学术带头人计划(17XD1402800);上海市卫计委重要薄弱学科建设项目(2016ZB0104);上海领军人才培养计划(2016),上海交通大学 “医工交叉研究基金”重点项目(YG2016ZD04)。

Abstract: Objective To determine the association among maternal sleep in late pregnancy, insulin level, and insulin resistance in offspring at the age of 2 years old by establishing a birth cohort. Methods Totally 255 healthy late pregnancy women (pregnant for 36~38 weeks) and their infants were recruited in this prospective cohort study from Renji Hospital in Shanghai. Actigraph was used to measure sleep parameters in women during late pregnancy. Random venous blood was collected at 2 years of follow-up in children for measuring glucose and insulin levels. Insulin resistance was assessed using homeostasis model assessment for insulin resistance (HOMA-IR), and HOMA-IR=[glucose (mmol/l)×insulin (uU/ml)]/22.5. Results The levels of glucose, insulin and HOMA-IR were (4.58 ±0.53) mmol / L, (4.65 ±3.61) μU / ml and (0.98 ±0.84) respectively in children at the age of 2 years old. After adjustment for maternal age in late pregnancy, educational level, family income and children′ gender, the longer wake time after sleep onset of late pregnancy women at night, the higher insulin level(β=0.236,P=0.016) and higher insulin resistance (β=0.241,P=0.015) were observed in offspring at the age of 2 years old. Conclusions The wake time after sleep onset of late pregnancy women is significantly associated with insulin and insulin resistance level in offspring at the age of 2 years old, which suggests that health care providers should pay more attention and improve sleep quality of women in the third trimester of pregnancy, thereby improving the metabolic outcome of the offspring.

Key words: late pregnancy, sleep, offspring, insulin, insulin resistance

摘要: 目的 通过建立出生队列研究孕晚期母亲睡眠与子代2岁胰岛素水平和胰岛素抵抗之间的相关性。方法 在上海浦东新区仁济医院招募255位健康孕晚期(孕36~38周)母亲及其婴儿入组,采用手表式睡眠-活动记录仪(actigraph)评估孕晚期母亲的睡眠状况,在儿童2岁时采集随机静脉血,检测血糖和胰岛素水平。胰岛素抵抗用HOMA-IR来评估,HOMA-IR=[血糖(mmol/l)×胰岛素(μU/ml)]/22.5。结果 儿童在2岁时平均血糖为(4.58±0.53)mmol/L,胰岛素为(4.65±3.61)μU/mL,HOMA-IR为0.98±0.84。在校正了孕晚期母亲年龄,受教育程度,家庭经济收入和儿童性别之后,孕晚期母亲夜间入睡后觉醒时间越长,其子代在2岁时的胰岛素水平越高(β=0.236,P=0.016),胰岛素抵抗指数越高(β=0.241,P=0.015)。结论 孕晚期母亲入睡后觉醒时间与其子代2岁时胰岛素和胰岛素抵抗密切相关,提示孕期保健医护人员应密切关注并改善孕晚期母亲的睡眠状况,以改善子代的代谢结局。

关键词: 孕晚期, 睡眠, 子代, 胰岛素, 胰岛素抵抗

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