Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Abstract

Background: Birth dimensions have been associated with increased risk of both, severe mental illness and type 2 diabetes in adulthood, however, any influence on their co-occurrence has never been examined. This cohort study examine whether birth weight/ponderal index explain or modify the later association between severe mental illness and risk of type 2 diabetes. Methods: The Metropolit cohort included 10,863 Danish men born in 1953 with information from age at conscription (between1971-84) until February 15th, 2018. Severe mental illness was defined as the exposure and information was retrieved from the national Danish health registries. Information on type 2 diabetes diagnosis or oral antidiabetic prescriptions was also obtained, as they were the outcome of interest. Information on birth weight/ponderal index was available from birth certificates. Cox proportional hazards regression models were used to estimate the associations and interactions were tested. Results: After 47.1 years of follow-up, 848 (7.8%) and 1320 (12.2%) men developed a severe mental illness or diabetes, respectively. Men with severe mental illness presented higher risk of subsequent diabetes (HR = 1.92; 95%CI, 1.61–2.30). This association was stronger in severe mental ill men with low birth weight (HR = 3.58; 95%CI, 2.11–6.07), than in those normal birth weight (HR = 1.79; 95%CI, 1.45–2.20). This effect modification was most evident for men diagnosed with schizophrenia. Conclusions: Birth information on birth weight/ponderal index could be of interest in diabetes screening on severe mental ill populations (especially in schizophrenia) since they might play a critical role in the increased risk of type 2 diabetes following severe mental illness.

Anthropometry in antipsychotic-naïve first-episode psychosis patients: An exploratory approach to the role of environmental early life events in two independent samples

“…Our results are in line with other studies where BW was associated with outcomes related with anthropometry. BW has been associated with antipsychotic-induced obesity (Ziauddeen et al, 2016) and with T2DM in schizophrenia (Fernandez-Egea et al, 2020) and in severe mental illness (Garriga et al, 2019b;Wium-Andersen et al, 2022). Previous articles suggest that some risk is present at onset (associated with different BW) and is related with the later development of metabolic abnormalities.…”

The effect of early life events on glucose levels in first-episode psychosis

“…Interestingly, male fetuses tend to grow faster than female at early stages making them more vulnerable to stressors (34) such as maternal stress Several studies have described factors affecting antipsychoticinduced weight gain in FEP patients, which can be theoretically translated as factors of glucose abnormalities (4,36). However, only a few studies have focused on the effect of early life events, either perinatal (20,(22)(23)(24)(25) or postnatal (37,38).…”

“…Several studies have described factors affecting antipsychotic-induced weight gain in FEP patients, which can be theoretically translated as factors of glucose abnormalities ( 4 , 36 ). However, only a few studies have focused on the effect of early life events, either perinatal ( 20 , 22 – 25 ) or postnatal ( 37 , 38 ).…”

“…This approach was additionally proved in the general population, where BW correlated with later medical events in adulthood ( 14 , 19 ). In a population-based cohort study, BW modified the effect of the correlation between BW and T2DM in patients with serious mental illnesses, and low and high BW were correlated in a quadratic form with higher prevalence of T2DM in patients diagnosed with schizophrenia ( 20 ). In another population-based cohort study including patients with schizophrenia among other diagnoses, BW was a risk factor for T2DM but did not modify the association with psychotropic medication ( 21 ).…”

Programación fetal metabólica en la salud mental

“…En un estudio poblacional, se ha demostrado que el peso al nacer modifica la asociación entre el diagnóstico de TMS y el desarrollo de DMT2 (10). Específicamente esta asociación existente en población general es mayor en pacientes diagnosticados con esquizofrenia y tendría una relación cuadrática, es decir tanto pesos al nacer muy bajos como muy altos se asociarían a una mayor prevalencia de DMT2.…”