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23-11-2011 | Diabetes | Article

Birthweight, weight during infancy linked to diabetes risk

Abstract

Free abstract

MedWire News: Birth weight and weight gain after 48 months of age are associated with risk for diabetes during adulthood, suggests a study of birth cohorts in low- and middle-income countries.

Weight at 28 and 48 months and weight gain in infants under 48 months of age, however, are not related to risk for the condition, write Shane Norris (University of the Witswatersrand, Johannesburg, South Africa) and colleagues in the journal Diabetes Care.

The team pooled data from five birth cohort studies involving 6511 participants from Brazil, Guatemala, India, the Philippines, and South Africa, and examined the association of weight and weight gain throughout infancy and adulthood with glycemic parameters.

The study revealed that birthweight was inversely associated with adult fasting glucose levels and with prevalence of impaired fasting glucose (IFG) and diabetes.

For each 1-standard deviation (SD) increase in birthweight - equivalent to approximately 5 kg - fasting glucose fell by 0.025 SD and the risk for IFG or diabetes fell by 9%. There was no such association with weight at 24 or 48 months of age, however.

Conditional weight gain (CWG), defined as deviation from expected weight gain, between 0-24 months and 24-48 months was not associated with fasting glucose or the development of IFG or diabetes in adulthood.

However, between 48 months and adulthood there was a 32% increased risk for IFG or diabetes for each 1-SD increment in CWG.

After adjusting for adult waist circumference, there was an inverse association between IFG or diabetes and birthweight, weight at 24 and 48 months, and CWG between birth and 24 months.

Birthweight showed no association with homeostatic model assessment of insulin resistance (HOMA-IR) whereas CWG in any period was significantly associated with increased HOMA-IR.

After adjusting for waist circumference, HOMA-IR was inversely associated with birth weight.

"Our interpretation is that for any given adult, waist circumference, higher birthweight and/or infant weight and weight gain are associated with a lower adult insulin resistance and diabetes risk," say Norris et al.

There may be a component of early weight or early weight gain, such as lean tissue or muscle mass, that is not associated with larger adult waist circumference and may be protective against diabetes onset, they suggest.

Therefore, "infancy and early childhood may be an important window of opportunity to promote weight gain in low- and middle-income country populations to improve survival and adult human capital without exacerbating adult diabetes risk," write the researchers.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Sally Robertson

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