Fetal origins of adult disease: epidemiology and mechanisms

Byrne, Christopher D.; Phillips, Diw

doi:10.1136/jcp.53.11.822

Cited by 85 publications

(65 citation statements)

References 50 publications

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“…41 Also, intrauterine growth retardation (low birth weight) has been linked with both unfavourable WHR and disease at adult age (Barker hypothesis). 42,43 An altered development of the pancreas or altered insulin sensitivity of target tissues may be some of the foetal changes causing type II diabetes later. 44 A lower birth weight has recently been shown to be associated with lower lean mass in later life.…”

Section: Discussionmentioning

confidence: 99%

Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study

et al. 2004

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OBJECTIVE: Fat distribution as measured by waist-to-hip ratio has been shown to be an important independent predictor of glucose intolerance. Few studies, however, have considered the contributions of the waist and hip circumferences independently. The aim of this study was to investigate the independent associations of waist and hip circumference with diabetes in a large population-based study, and to investigate whether they also apply to other major components of the metabolic syndrome (hypertension and dyslipidemia). In addition, as previous studies were performed in older persons, we investigated whether these associations were present across adult age groups. METHODS: Weight, height, waist and hip circumferences were measured in 11 247 participants of the nationally representative Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. HDL-cholesterol, triglycerides, fasting and 2-h postload glucose were determined, and diastolic and systolic blood pressure was measured. After exclusion of persons already known to have diabetes, hypertension or dyslipidemia, logistic and linear regression were used to study cross-sectional associations of anthropometric variables with newly diagnosed diabetes, hypertension and dyslipidemia, and with continuous metabolic measures, all separately for men (n ¼ 3818) and women (n ¼ 4582). Analyses were repeated in the same population stratified for age. RESULTS: After adjustment for age, body mass index and waist, a larger hip circumference was associated with a lower prevalence of undiagnosed diabetes (odds ratio (OR) per one s.d. increase in hip circumference 0.55 (95% CI 0.41-0.73) in men and 0.42 (0.27-0.65) in women) and undiagnosed dyslipidemia (OR 0.58 (0.50-0.67) in men and 0.37 (0.30-0.45) in women). Associations with undiagnosed hypertension were weaker (OR 0.80 (0.69-0.93) in men and 0.88 (0.70-1.11) in women). As expected, larger waist circumference was associated with higher prevalence of these conditions. Similar associations were found using continuous metabolic variables as outcomes in linear regression analyses. Height partly explained the negative associations with hip circumference. When these analyses were performed stratified for age, associations became weaker or disappeared in the oldest age groups (age Z75 y in particular), except for HDL-cholesterol. CONCLUSION: We found independent and opposite associations of waist and hip circumference with diabetes, dyslipidemia and less strongly with hypertension in a large population-based survey. These results emphasize that waist and hip circumference are important predictors for the metabolic syndrome and should both be considered in epidemiological studies. The associations were consistent in all age groups, except in age Z75 y. Further research should be aimed at verifying hypotheses explaining the 'protective' effect of larger hips.

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Section: Discussionmentioning

confidence: 99%

Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study

et al. 2004

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“…For instance, coronary heart disease, type 2 diabetes, atherosclerosis, and arterial hypertension have been associated with fetal growth retardation (1,2). These observations have led to the hypothesis that diseases in the adult, including cardiovascular disorders, may already be determined during intrauterine life.…”

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confidence: 99%

Chronic Moderate Hypoxia and Protein Malnutrition Both Induce Growth Retardation, But Have Distinct Effects on Arterial Endothelium-Dependent Reactivity in the Chicken Embryo

Ruijtenbeek¹,

Kessels²,

Mey

et al. 2003

Pediatr Res

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“…1,2 Widely reported data from epidemiological studies implicate adverse influence during fetal, infant, and early childhood growth that might ultimately lead to the early onset of cardiovascular diseases, hypertension, and diabetes. 3 The specific mechanisms underlying these associations, however, are far from clear.…”

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confidence: 99%

Effect of Birth Parameters on Retinal Vascular Caliber

et al. 2009

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Abstract-Recent studies reported an association between smaller birth size and narrower retinal vascular caliber, but it remains unclear whether this association is attributed to confounding by shared environment or genetic factors. At a mean age of 9.3 years, 266 twins (49 monozygotic and 84 dizygotic pairs) in the Twins Eye Study in Tasmania underwent an ophthalmic examination including retinal photography. Retinal vascular caliber was measured using a validated protocol. The majority of these twins were also in the Tasmanian Infant Health Study, which prospectively collected data on birth parameters and antenatal maternal factors. We conducted the main analysis using linear mixed models, accounting for birth set clustering. Key Words: twins Ⅲ epidemiology Ⅲ blood pressure Ⅲ arterioles Ⅲ birth weight Ⅲ birth length Ⅲ head circumference E vidence to support the hypothesis of the fetal origins of adult disease has accumulated in the last decade. 1,2 Widely reported data from epidemiological studies implicate adverse influence during fetal, infant, and early childhood growth that might ultimately lead to the early onset of cardiovascular diseases, hypertension, and diabetes. 3 The specific mechanisms underlying these associations, however, are far from clear.Study of retinal microvascular changes attributed to fetal and perinatal influences offers a unique opportunity to uncover the underlying causal pathways of fetal origins of adulthood vasculopathies. Using new computer-based retinal imaging techniques, we have shown that precisely measured retinal arteriolar narrowing is a strong marker for the development of hypertension and cardiovascular events, including myocardial infarction. 4 -6 New studies now demonstrate that lower birth weight is associated with narrower retinal arterioles, 7,8 narrower bifurcation angle, 9 higher retinal vessel tortuosity, and optimality deviance, 10 providing initial evidence that fetal origins of cardiovascular disease may partly be mediated by the microcirculation. However, it could be argued that the association between birth weight and microvascular alternation may be confounded by genetic or shared environmental factors (eg, maternal nutrition) that affect both birth size and abnormal microvascular structural development. It is also commonly understood that variation in almost all human traits and diseases has some genetic component, and this is evident for retinal vascular caliber 11,12 and size at birth. 13

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Fetal origins of adult disease: epidemiology and mechanisms

Cited by 85 publications

References 50 publications

Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study

Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study

Chronic Moderate Hypoxia and Protein Malnutrition Both Induce Growth Retardation, But Have Distinct Effects on Arterial Endothelium-Dependent Reactivity in the Chicken Embryo

Effect of Birth Parameters on Retinal Vascular Caliber

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