Birth weight of offspring and insulin resistance in late adulthood: cross sectional survey

doi:10.1136/bmj.325.7360.359

BMJ 2002;325:359 ( 17 August )

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Birth weight of offspring and insulin resistance in late adulthood: cross sectional survey

Debbie A Lawlor, MRC research training fellow, George Davey Smith, professor of clinical epidemiology, Shah Ebrahim, professor of epidemiology of ageing.

Department of Social Medicine, University of Bristol, Bristol BS8 2PR

Correspondence to: D A Lawlor d.a.lawlor{at}bristol.ac.uk

Objective: To investigate the association between birthweight of offspring and mothers' insulin resistance in lateadulthood.
Design: Cross sectionalsurvey.
Setting: General practitioner's surgeries in 23 townsin GreatBritain.
Participants: 4286 women aged 60-79years.
Main outcome measures: Maternal insulinresistance.
Results: Birth weight of offspring was inversely relatedto maternal insulin resistance in late adulthood. For each 1 kghigher birth weight of offspring, women had a 15% reduction inthe odds of being in the fourth with highest insulin resistance,compared to other fourths (odds ratio 0.85; 95% confidence interval0.71 to 1.00). This increased to 27% (0.73; 0.60 to 0.90) afteradjusting data for potential confounders. A U shaped relationbetween birth weight of offspring and diabetes in older age wasfound; women with the lightest and heaviest offspring had thehighest prevalence ofdiabetes.
Conclusions: Birth weight of offspring is inversely relatedto the mother's insulin resistance in late adulthood, despitethe association of glucose intolerance during pregnancy with heavieroffspring at birth. Common genetic factors contribute to the relationbetween birth weight and risk of cardiovascular disease and diabetesinadults.

What is already known on this topic
Small birth weight is related to increased risk of cardiovascular disease and diabetes in adulthood; the underlying mechanisms are unclear

Small birth weight of offspring is related to parental cardiovascular disease, suggesting that common genetic factors affect birth weight and the risk of disease in adulthood

Genetic factors associated with the metabolism of insulin are plausible in linking birth weight and cardiovascular disease (the fetal insulin hypothesis)

What this study adds
Birth weight of offspring is inversely related to maternal insulin resistance in older age

Genetic factors related to both insulin resistance and birth weight explain at least part of the association between birth weight and risk of cardiovascular disease and diabetes in adulthood

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Rapid Responses:

Read all Rapid Responses

Hyperinsulinemia-Insulin Resistance is now-a-days a "clinical" Diagnosis.: Sergio Stagnaro
bmj.com, 16 Aug 2002 [Full text]
Low DHEA May Explain These Findings: James M. Howard
bmj.com, 17 Aug 2002 [Full text]
The "U shaped Relationship" is due to loss of DHEA: James M. Howard
bmj.com, 17 Aug 2002 [Full text]
Hypertension in Mother with low birth weight: Debasish Banerjee
bmj.com, 19 Aug 2002 [Full text]
Transfer of Disease from unborn child to mother: Anita Banerjee
bmj.com, 20 Aug 2002 [Full text]
Re: Transfer of Disease from unborn child to mother: James M. Howard
bmj.com, 21 Aug 2002 [Full text]
Transgenerational link with maternal insulin resistance may not be 'genetic': Henry S Kahn
bmj.com, 22 Aug 2002 [Full text]
Re: Re: Transfer of Disease from unborn child to mother: Anita Banerjee
bmj.com, 23 Aug 2002 [Full text]
Re: Transgenerational link with maternal insulin resistance may not be 'genetic': James M. Howard
bmj.com, 26 Aug 2002 [Full text]
Re: Re: Transgenerational link with maternal insulin resistance may not be 'genetic': James M. Howard
bmj.com, 27 Aug 2002 [Full text]
Offspring's birth weight and maternal insulin resistance: Chittaranjan Yajnik, et al.
bmj.com, 3 Sep 2002 [Full text]
Authors' reply: Trans-generational associations are present for fathers and mothers: Debbie A Lawlor, et al.
bmj.com, 3 Sep 2002 [Full text]
Authors' reply to Yajnik et al.: Debbie A Lawlor, et al.
bmj.com, 6 Sep 2002 [Full text]