Early origin of coronary heart disease (the "Barker hypothesis")

Paneth, Nigel; Susser, Mervyn

doi:10.1136/bmj.310.6977.411

Cited by 291 publications

(168 citation statements)

References 12 publications

Supporting

Mentioning

160

Contrasting

Unclassified

Order By: Relevance

“…Throughout the years, several hypotheses based on the concept of programming have been proposed to underlie this association, including the thrifty phenotype, fetal salvage, catch-up growth and stem-cell hypotheses [27][28][29][30]. There are also indications that the association is not the result of programming but of confounding (especially by socio-economic status), selective survival or response [31,32], or genes that affect both the path of early growth and insulin resistance [33]. Despite incomplete follow-up, our participants did not significantly differ from non-respondents in perinatal characteristics.…”

Section: Discussionmentioning

confidence: 99%

Preterm birth and later insulin resistance: effects of birth weight and postnatal growth in a population based longitudinal study from birth into adult life

et al. 2006

View full text Add to dashboard Cite

Aims/hypothesis: An increased risk of type 2 diabetes mellitus is associated with low birthweight after full-term gestation, including amplification of this risk by weight gain during infancy and adult body composition. Premature birth is also associated with insulin resistance, but studies conducted so far have not provided follow-up into adulthood. We studied the effects of (1) lower birthweight (as standard deviation score [SDS]) and infancy weight gain on insulin resistance in 19-year-olds born before 32 weeks of gestation, and (2) the interaction be-

show abstract

Section: Discussionmentioning

confidence: 99%

Preterm birth and later insulin resistance: effects of birth weight and postnatal growth in a population based longitudinal study from birth into adult life

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Interpretation of the birth weight effect after adjustment for current body size is controversial, 37,38 and results may be indicative that postnatal change in size, rather than fetal growth, is important. 18 The unadjusted association better represents the total effect of birth weight on the outcome of interest.…”

Section: Discussionmentioning

confidence: 99%

Birth Weight and Lipids in a National Birth Cohort Study

Skidmore

Hardy

Kuh

et al. 2004

ATVB

View full text Add to dashboard Cite

Objective-To investigate the association between birth weight and lipid levels in a 53-year-old birth cohort from England, Scotland, and Wales. Methods and Results-Lipid levels were obtained from nonfasting blood samples, collected at the most recent follow-up of the MRC National Survey of Health and Development, for 2559 men and women. Regression models indicated that in men, a 1-kg increase in birth weight was associated with a 0.13-mmol/L decrease (95% CI: Ϫ0.23, Ϫ0.01) in total cholesterol at age 53 years (Pϭ0.03), compared with a 0.02-mmol/L (95% CI: Ϫ0.11, 0.15) increase in women and a 0.06-mmol/L (95% CI: Ϫ0.15, 0.02) decrease in men and women combined. Adjustment for current height and body mass index (BMI) in men reduced the size of the relationship, with height being responsible for the reduction. Adult height and height at 2 and 4 years were significantly associated with total cholesterol in men and in men and women combined. The negative association between total cholesterol and birth weight was strongest among men with high BMI at age 53 years (Pϭ0.03 for test for interaction between birth weight and BMI). There was no significant association between birth weight and LDL or HDL cholesterol in men or women before adjustment, but there was a positive association with HDL in women. When both sexes were analyzed together, an association was seen after adjustment for current body size. No confounding of these findings with social class was observed in this study. Conclusions-Our results suggest that the small effect of birth weight on lipid levels at age 53 years has a limited public health impact. The findings suggest that childhood height growth may be more important than prenatal growth. Key Words: birth weight Ⅲ height Ⅲ body mass index Ⅲ cholesterol Ⅲ epidemiology H igh blood cholesterol is an important risk factor for cardiovascular disease 1 and may be programmed in early life. 2 According to Barker's fetal origins hypothesis, 2 impaired fetal growth that leads to changes in lipid metabolism is one explanation for the observed inverse associations between birth weight and other measures of size at birth and adult cardiovascular disease. 3,4 Results from studies relating markers of fetal growth to adult lipid levels have, however, been inconsistent 3,5-9 and a recent meta-analysis estimated a decrease of only 0.05 mmol/L per 1 kg increase in birth weight. 10 To our knowledge, all except one study 7 of European adults 3,5,6,8,[11][12][13][14][15] have fewer than 800 subjects and may therefore have lacked the power to test for sex differences. Sex differences in the association between fetal growth and later coronary heart disease risk might be anticipated if fetal nutrition is the underlying mechanism because male fetuses grow at a faster rate, on average, than female fetuses. 16 However, discussion of sex differences based on separate analyses for males and females, without statistical tests of interaction, may result in an overemphasis of chance differences. 17 Adjustment of the birth weight effec...

show abstract

“…In addition, follow-up of this cohort was virtually complete after 45 years, and there were no differences in the birth characteristics of the women with completed home interviews (~85 percent) and those without completed home interviews. For these reasons, concerns about the possibility of confounding by a lack of control for socioeconomic status and the potential for selection bias due to incomplete follow-up (34,35) do not apply to this cohort.…”

Section: Discussionmentioning

confidence: 99%