香港中文大学：研究警示懷孕妇女要注意體重增幅 CUHK Studies Alert Mothers to Pregnancy Weight Gain

香港中文大學 香港中文大医院 CU Faculty of Medicine The Chinese University of Hong Kong The Chinese University of Hong Kong 中大研究警示懷孕妇女要注意體重增幅 CUHK Studies Alert Mothers to Pregnancy Weight Gain

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong

Increasing diabetes in adults and children 糖尿病成人及兒童患者上升 DM in adults in china Type 2 DM in Children in Hong Kong 中國糖尿病成年患者 香港二型糖尿病兒童患者 Slope 0.314 incr/year pm0.00 19801935199019952000200520102015 Calendar Year New cases increased 10x Between 1997-2007 Prevalence increased 10x Between 1980-2014 Huen ke et al. hk journal of paed 2009 Ma RC diabetologia 2018 Feb 1 香港中文大學 The Chinese University of Hong Kong

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong Increasing diabetes in adults and children 糖尿病成人及兒童患者上升 Ma RC. Diabetologia 2018 Feb 1 DM in adults in China 中國糖尿病成年患者 Type 2 DM in Children in Hong Kong 香港二型糖尿病兒童患者 Huen KF et al, HK Journal of Paed 2009 New cases increased 10x Between 1997-2007 Prevalence increased 10x Between 1980-2014

Global increase in childhood obesity 全球兒童期肥胖個案不斷上升 □ West Africa Polynesia and Micronesia Central Africa Caribbean uthern 口 Andean Latin America East africa Central Latin america 60口 Middle east and north Africa■ I Southern Latin America CentralAsia 口 High-income English- South asia speaking countries Childhood and Southeast asia □ Northwestern Europe □ East asia □ Southwestern Europe adolescent obesity 口 High-income Asia Pacif Central Europe Melanesia Eastern Europe increased 10x over 4 decades 兒童期及青少年期肥胖 個案於40多年間急升10倍 0 1980 1990 2000 2010 Global burden of disease. Lancet 2017 oct 10 香港中文大學 The Chinese University of Hong Kong

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong Global increase in childhood obesity 全球兒童期肥胖個案不斷上升 Global Burden of Disease. Lancet 2017 Oct 10 1980 1990 2000 2010 Childhood and adolescent obesity increased 10x over 4 decades 兒童期及青少年期肥胖 個案於40多年間急升10倍

Burden of Hyperglycaemia in Pregnancy 懷孕期高血糖 Hyperglycaemia in Pregnancy estimated to affect 1 in 6 pregnancies globally(approx. 20 million birhts/year) Majority(85%)due to Gestational Diabetes Tianjin, China -GDM prevalence Children born to gdm mothers "DM prevalence More likely to be overweight 6 GDM Have higher blood pressure Prevalence Have higher risk of dm later (%) IDF Diabetes Atlas, 7th Edition 2015 Zhang F et al, Diabet Med 2011 ng J et al, PLoS One 2015 Ma rc et al. Eur j clin Nutr 2017 香港中文大學 The Chinese University of Hong Kong

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong IDF Diabetes Atlas, 7th Edition, 2015 Zhang F et al, Diabet Med 2011 Leng J et al, PLoS One 2015 Ma RC et al, Eur J Clin Nutr 2017 • Hyperglycaemia in Pregnancy estimated to affect 1 in 6 pregnancies globally (approx. 20 million birhts/year) • Majority (85%) due to Gestational Diabetes Burden of Hyperglycaemia in Pregnancy 懷孕期高血糖 GDM Prevalence (%) Tianjin, China Children born to GDM mothers - More likely to be overweight - Have higher blood pressure - Have higher risk of DM later

2001年至2006年 中大醫學院曾參與國際性大型硏究「高血糖與不 良懷孕結果」( Hyperglycemia and adverse Pregnancy Outcome study,簡稱「HAPO研究」) 全球15個地區超過2.5萬名孕婦 探討妊娠期間母親高血糖對懷孕的不良影響,以 制定妊娠糖尿病( gestational diabetes mellitus, GDM)的標準 香港中文大學 The Chinese University of Hong Kong CU Faculty of Medicine

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong 2001年 至 2006年 ➢ 中大醫學院曾參與國際性大型研究「高血糖與不 良懷孕結果」 (Hyperglycemia and adverse Pregnancy Outcome study, 簡稱「HAPO研究」) ➢ 全球15個地區超過2.5萬名孕婦 ➢ 探討妊娠期間母親高血糖對懷孕的不良影響，以 制定妊娠糖尿病 (gestational diabetes mellitus, GDM) 的標準

全球15個「HAPO研究」中心 已米 Cleveland Bellflower Bangkok Bridgetown, Babados Hong Kong Brisbane 香港中文大學 The Chinese University of Hong Kong

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong Bellflower Chicago Cleveland Providence Toronto Belfast Manchester Bridgetown, Babados Petah Tiqva Beersheba Bangkok Singapore Brisbane Newcastle Hong Kong 全球 15 個「 HAPO 研究」中心

2009-2013年 中大為970名曾參與HAPO研究的母親及其約 7歲的子女進行跟進研究 口包括口服葡萄糖耐量測試 (oral glucose tolerance test, OGTT 探討妊娠糖尿病對下—代的影響 研究結果已於醫學期刊《 Diabetes care》發表 研究獲大學教育資助委員會資助 香港中文大學 The Chinese University of Hong Kong CU Faculty of Medicine

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong 2009 - 2013年 ➢ 中大為 970 名曾參與 HAPO研究的母親及其約 7歲的子女進行跟進研究 ❑ 包括口服葡萄糖耐量測試 (oral glucose tolerance test, OGTT) ➢ 探討妊娠糖尿病對下一代的影響 ➢ 研究結果已於醫學期刊《Diabetes Care》發表 ➢ 研究獲大學教育資助委員會資助

Diabetes Care Volume 40, May 2017 679 In Utero Exposure to maternal Hyperglycemia Increases Albert Martin Ll, Michoel Ho Ming Chan, Lai Yuk Yuen, Terence Tzu Hsi Loo, I Childhood Cardiometabolic risk Xilin Yang, Chung Shun地o Gregory Emanuele Tutino, " and in Offspring uliana Chung Ngor Chan'34 Diabetes Care201740679686|Do:10.2337/0c162397 相比一般孕婦,患有妊娠糖尿病的孕婦誕下之子女 口糖尿病前期或糖尿病的機會率:3倍 口超重及肥胖的風險:高50% 口血壓水平:高10% 香港中文大學 The Chinese University of Hong Kong CU Faculty of Medicine

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong ➢ 相比一般孕婦，患有妊娠糖尿病的孕婦誕下之子女 ❑ 糖尿病前期或糖尿病的機會率 : 3倍 ❑ 超重及肥胖的風險 : 高 50% ❑ 血壓水平 : 高10%

最近一項中大參與的國際研究 印證本團隊上年度發表的結果 Research JAMA 2018: Sept 11 JAMA I Original Investigation Association of gestational diabetes With maternal disorders of Glucose Metabolism and Childhood Adiposity William L. Lowe Jr, MD: Denise M. Scholtens, PhD: Lynn P Lowe, PhD: Alan Kuang, MS: Michael Nodzenski, MS: Octavious Talbot, MS Patrick M. Catalano, MD: Barbara Linder, MD, PhD; Wendy J. Brickman, MD: Peter Clayton, MD: Chaicharn Deerochanawong, MD: Jill Hamilton, MD Jami L Josefson, MD, MS: Michele Lashley, MBBS, DM; Jean M. Lawrence, ScD: Yael Lebenthal, MD: Ronald Ma, MB, BChir, FRCP Michael Maresh, MD, FRCOG: David McCance, MD: Wing Hung Tam, MD: David A Sacks, MD: Alan R Dyer, PhD: Boyd E. Metzger, MD: for the HAPO Follow-up Study Cooperative Research Group Between 2013-2016, 4832 children, mean FU 114yrs Maternal gdm associated with 50% increase in childhood overweight or obesity 香港中文大學 ESor The Chinese University of Hong Kong CU Faculty of Medicine

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong • Between 2013-2016, 4832 children, mean FU 11.4yrs • Maternal GDM associated with 50% increase in childhood overweight or obesity JAMA 2018; Sept 11 最近一項中大參與的國際研究 印證本團隊上年度發表的結果

2013-2016年 全球10個硏究中心為4,832名曾參與HAPO 研究的母親及其約11-14歲的子女進行跟進研 究(本院是其中一個研究中心) 相比一般孕婦,患有妊娠糖尿病的孕婦誕下 之子女 口肥胖的風險:高50% 香港中文大學 The Chinese University of Hong Kong CU Faculty of Medicine

Copyright © 2018. All Rights Reserved. Faculty of Medicine, The Chinese University of Hong Kong 2013 - 2016年 ➢ 全球10個研究中心為 4,832 名曾參與 HAPO 研究的母親及其約11-14歲的子女進行跟進研 究 (本院是其中一個研究中心) ➢ 相比一般孕婦，患有妊娠糖尿病的孕婦誕下 之子女 ❑ 肥胖的風險 : 高 50%