Association between birth weight and diabetes: Role of body mass index and lifestyle in later life
中国中老年人群出生体重与糖尿病风险的相关性研究:探讨成年后体重指数与生活方式的作用
Chunyan Hu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorYiming Mu
Chinese People's Liberation Army General Hospital, Beijing, China
Search for more papers by this authorQin Wan
The Affiliated Hospital of Southwest Medical University, Luzhou, China
Search for more papers by this authorYingfen Qin
The First Affiliated Hospital of Guangxi Medical University, Nanning, China
Search for more papers by this authorRuying Hu
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
Search for more papers by this authorLixin Shi
Affiliated Hospital of Guiyang Medical College, Guiyang, China
Search for more papers by this authorQing Su
Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorXuefeng Yu
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for more papers by this authorLi Yan
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorGuijun Qin
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Search for more papers by this authorXulei Tang
The First Hospital of Lanzhou University, Lanzhou, China
Search for more papers by this authorGang Chen
Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
Search for more papers by this authorGuixia Wang
The First Hospital of Jilin University, Changchun, China
Search for more papers by this authorFeixia Shen
The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Search for more papers by this authorZuojie Luo
The First Affiliated Hospital of Guangxi Medical University, Nanning, China
Search for more papers by this authorYanan Huo
Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
Search for more papers by this authorQiang Li
The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Search for more papers by this authorZhen Ye
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
Search for more papers by this authorYinfei Zhang
Central Hospital of Shanghai Jiading District, Shanghai, China
Search for more papers by this authorChao Liu
Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
Search for more papers by this authorYoumin Wang
The First Affiliated Hospital of Anhui Medical University, Hefei, China
Search for more papers by this authorShengli Wu
Karamay Municipal People's Hospital, Xinjiang, China
Search for more papers by this authorTao Yang
The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
Search for more papers by this authorHuacong Deng
The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorLulu Chen
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for more papers by this authorJiajun Zhao
Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
Search for more papers by this authorJieli Lu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorLin Lin
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorMian Li
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorRui Du
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorMin Xu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorYu Xu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorTiange Wang
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorZhiyun Zhao
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorYuhong Chen
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorDonghui Li
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Search for more papers by this authorCorresponding Author
Yufang Bi
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Correspondence
Yufang Bi, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin 2nd Road, Shanghai 200025, China.
Email: [email protected]
Search for more papers by this authorWeiqing Wang
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorGuang Ning
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorfor the REACTION Study Group
Search for more papers by this authorChunyan Hu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorYiming Mu
Chinese People's Liberation Army General Hospital, Beijing, China
Search for more papers by this authorQin Wan
The Affiliated Hospital of Southwest Medical University, Luzhou, China
Search for more papers by this authorYingfen Qin
The First Affiliated Hospital of Guangxi Medical University, Nanning, China
Search for more papers by this authorRuying Hu
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
Search for more papers by this authorLixin Shi
Affiliated Hospital of Guiyang Medical College, Guiyang, China
Search for more papers by this authorQing Su
Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorXuefeng Yu
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for more papers by this authorLi Yan
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorGuijun Qin
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Search for more papers by this authorXulei Tang
The First Hospital of Lanzhou University, Lanzhou, China
Search for more papers by this authorGang Chen
Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
Search for more papers by this authorGuixia Wang
The First Hospital of Jilin University, Changchun, China
Search for more papers by this authorFeixia Shen
The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Search for more papers by this authorZuojie Luo
The First Affiliated Hospital of Guangxi Medical University, Nanning, China
Search for more papers by this authorYanan Huo
Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
Search for more papers by this authorQiang Li
The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Search for more papers by this authorZhen Ye
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
Search for more papers by this authorYinfei Zhang
Central Hospital of Shanghai Jiading District, Shanghai, China
Search for more papers by this authorChao Liu
Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
Search for more papers by this authorYoumin Wang
The First Affiliated Hospital of Anhui Medical University, Hefei, China
Search for more papers by this authorShengli Wu
Karamay Municipal People's Hospital, Xinjiang, China
Search for more papers by this authorTao Yang
The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
Search for more papers by this authorHuacong Deng
The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorLulu Chen
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for more papers by this authorJiajun Zhao
Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
Search for more papers by this authorJieli Lu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorLin Lin
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorMian Li
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorRui Du
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorMin Xu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorYu Xu
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorTiange Wang
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorZhiyun Zhao
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorYuhong Chen
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorDonghui Li
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Search for more papers by this authorCorresponding Author
Yufang Bi
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Correspondence
Yufang Bi, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin 2nd Road, Shanghai 200025, China.
Email: [email protected]
Search for more papers by this authorWeiqing Wang
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorGuang Ning
Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Search for more papers by this authorfor the REACTION Study Group
Search for more papers by this authorAbstract
enBackground
This study investigated the association between birth weight and diabetes in a Chinese population, and the effects of body mass index (BMI) and lifestyle factors in later life on this association.
Methods
Data from 49 118 participants aged ≥40 years with recalled birth weight from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, a nationwide population-based cohort, were used. Diabetes diagnosis was based on oral glucose tolerance tests and HbA1c measurements. Logistic regression models were used to evaluate the association of birth weight and risk of diabetes in later life.
Results
Increased risk of diabetes was associated with lower or higher birth weight. Compared with individuals with a birth weight of 2500 to 3499 g, the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes for individuals with a birth weight of <2500, between 3500 and 3999, and ≥4000 g were 1.28 (1.11-1.47), 1.11 (1.04-1.19), and 1.20 (1.07-1.34), respectively. Significant associations were prominent in participants with a current BMI ≥24 kg/m2, but not detected in those with a normal BMI (OR 1.20 [95% CI 0.96-1.49], 1.11 [95% CI 0.98-1.25], and 1.10 [95% CI 0.89-1.37], respectively). Moreover, there was no increased risk of diabetes in individuals with a low birth weight but with healthy dietary habits (OR 0.94; 95% CI 0.68-1.29) or ideal physical activity (OR 1.41; 95% CI 0.97-2.04).
Conclusions
A U-shaped association was observed between birth weight and the risk of diabetes. Healthy lifestyles (healthy dietary habits or ideal physical activity) may eliminate the negative effects of low birth weight in the development of diabetes, but not the effect of high birth weight.
摘要
zh背景
本研究旨在调查中国中老年人群出生体重与糖尿病之间的关系, 以及成年后体重指数(body mass index, BMI)和生活方式是否会影响这种关联。
方法
我们的研究人群来自全国性的REACTION研究, 即中国2型糖尿病患者肿瘤发生风险的流行病学研究(Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study, REACTION)。最终, 49118名40岁及以上的参与者被纳入研究, 并按回忆的出生体重分为四组:<2500 g, 2500~3499 g, 3500~3999 g, ≥4000 g。 糖尿病的诊断基于口服葡萄糖耐量试验和糖化血红蛋白测定。Logistic回归模型用于评估出生体重与成年后糖尿病风险之间的关系。
结果
低出生体重或高出生体重都与成年后糖尿病发生有关。与出生体重2500~3499g的人相比, 出生体重<2500g、3500~3999g、≥4000g的参与者其多因素校正后的糖尿病比值比(OR)和95%置信区间(CI)分别为1.28(1.11~1.47), 1.11(1.04~1.19)和1.20(1.07~1.34)。在BMI ≥ 24 kg/m2的参与者中, 出生体重与糖尿病的这种相关性显著, 但在BMI正常者中无显著差异(OR, 95% CI分别为:1.20, 0.96~1.49；1.11, 0.98~1.25和1.10, 0.89~1.37)。此外, 在低出生体重但饮食习惯健康或具有理想体力活动的人群中并未发现糖尿病风险显著升高(OR, 95% CI分别为:0.94, 0.68~1.29；1.41, 0.97~2.04)。
结论
我们的研究表明, 出生体重和成年后糖尿病风险之间呈U形关联。健康的生活方式(如健康的饮食习惯或理想的体力活动)可以抵消低出生体重对糖尿病发生风险的影响, 但不能消除高出生体重的影响。
Supporting Information
| Filename | Description |
|---|---|
| jdb12960-sup-0001-Supinfo.docWord document, 69.5 KB |
Table S1. Comparison of characteristics between participants in the present study and those who were excluded. Table S2. Association of birth weight and the risk of developing diabetes in later life (excluding participants with missing lifestyle data). Table S3. Association of birth weight and the risk of diabetes in different body mass index and lifestyle categories. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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