Birth Weight, Early Weight Gain, and Subsequent Risk of Type 1 Diabetes: Systematic Review and Meta-Analysis

Abstract

Previous studies suggest that birth weight and weight gain during the first year of life are related to later risk of type 1 diabetes. The authors performed a systematic review and meta-analysis on these associations. Twelve studies involving 2,398,150 persons of whom 7,491 had type 1 diabetes provided odds ratios and 95% confidence intervals of type 1 diabetes associated with birth weight. Four studies provided data on weight and/or weight gain during the first year of life. High birth weight (>4,000 g) was associated with increased risk of type 1 diabetes (odds ratio = 1.17, 95% confidence interval (CI): 1.09, 1.26). According to sensitivity analysis, this result was not influenced by particular study characteristics. The pooled confounder-adjusted estimate was 1.43 (95% CI: 1.11, 1.85). No heterogeneity was found (I(2) = 0%) and no publication bias. Low birth weight (<2,500 g) was associated with a nonsignificantly decreased risk of type 1 diabetes (odds ratio = 0.82, 95% CI: 0.54, 1.23). Each 1,000-g increase in birth weight was associated with a 7% increase in type 1 diabetes risk. In all studies, patients with type 1 diabetes showed increased weight gain during the first year of life, compared with controls. This meta-analysis indicates that high birth weight and increased early weight gain are risk factors for type 1 diabetes.

Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data

“…Compared with our analysis, that previous work observed a slightly more marked 17% increase in diabetes risk in children weighing over 4.0 kg at birth, relative to children weighing under 4.0 kg (prior to adjustment for confounders). Although reported for 'orientating purposes only' [45,46], the less comprehensive approach of that previous study to adjustment for various confounders produced a much more marked effect of birthweight, suggesting a 43% increase in diabetes risk (based on six studies). In contrast, our analysis, using individual patient data from 29 studies with no duplicated data [47], demonstrates that confounding by various perinatal factors (such as gestational age, maternal age, birth order, Caesarean section, maternal diabetes or breastfeeding) has little influence on the birthweight association.…”

“…A previous meta-analysis of birthweight and type 1 diabetes [45] included fewer studies than ours (and based its estimate for high birthweight upon ten studies only, whereas ours was based on 29 studies). Compared with our analysis, that previous work observed a slightly more marked 17% increase in diabetes risk in children weighing over 4.0 kg at birth, relative to children weighing under 4.0 kg (prior to adjustment for confounders).…”

The Pioneer Gut Microbiota in Human Neonates Vaginally Born at Term—A Pilot Study

“…High birth weight is known to have impact on risk of metabolic disturbances, such as type 1 diabetes and increased BMI, later in life (17,18). Obesity is a risk factor for type 2 diabetes and has recently been linked to differences in intestinal microbiota (19,20), but how the neonatal microbiota affects the homeostasis later in life is unknown.…”

The Enlarging List of Phenotypic Characteristics That Might Allow the Clinical Identification of Families at Risk for Type 1 Diabetes

“…Maternal obesity before pregnancy and weight gain during pregnancy significantly predicted increased risk of persistent multiple positivity for islet autoantibodies in offspring with high genetic susceptibility for type 1 diabetes (Rasmussen et al, 2009). A systematic review and meta-analysis (12 studies) indicated that high birth weight and increased weight gain during the first year of life were associated with an increased risk of type 1 diabetes in later life (Harder et al, 2009). Metabolic demand and insulin resistance have been suggested to be involved in the development of type 1 diabetes (Evertsen et al, 2009;Wilkin, 2009), but the evidence is not consistent across the studies.…”