Impact of birth weight on adult-onset diabetes mellitus in relation to current body mass index: The Japan Nurses' Health Study

Abstract

BackgroundAlthough birth weight is considered as a fetal determinant of the development of adult-onset diabetes mellitus (DM), its public health importance relative to adult body mass index (BMI) remains unclear. We aimed to examine the association between adult-onset DM and birth weight in relation to adult BMI.MethodsWe conducted a self-administered questionnaire as a baseline survey of the Japanese Nurses' Health Study cohort between 2001 and 2007. Exclusion criteria were applied to the volunteer sample of 49,927 female nurses (age <30 years or unknown, current pregnancy, development of DM before the age of 30 years, unknown core variables), and data from 26,949 female nurses aged 30 years or older were used. The association between history of DM diagnosis and birth weight was analyzed using logistic regression.ResultsA linear inverse association was observed between birth weight and DM, after adjustment for age, BMI, and parental history of DM. The odds ratio for developing DM per 100 g increase in birth weight was 0.93 (95% confidence interval [CI], 0.90–0.96). The association was unchanged when birth weight was converted to percentile for gestational age. In the BMI-stratified analysis, the odds ratio for DM in the <2500 g birth weight group reached 4.75 (95% CI, 1.22–18.44, compared to the reference 3000–3499 g group) among women with normal low BMI (18.5–20.9).ConclusionsBirth weight and its percentile for gestational age were associated with adult-onset DM. Attention should be paid to the risk of DM among women born with low weight, even when their current BMI is normal.

Being underweight in adolescence is independently associated with adult‐onset diabetes among women: The Japan Nurses’ Health Study

“…There is firm evidence, mostly from Western countries, that intrauterine growth restriction is associated with an increased risk of adult‐onset diabetes. We recently confirmed a similar association among the same Japanese female large‐scale cohort. That previous report showed that even among women with normal low BMI (18.5–20.9), the prevalence of adult‐onset diabetes was significantly higher in women with a low birthweight, which was consistent with the independent negative effect of birthweight shown in our path analysis.…”

“…Although adult obesity is an established risk factor for type 2 diabetes, accumulating evidence shows that bodyweight at earlier life stages might also plays a role. Low birthweight has been associated with an increased risk of adult type 2 diabetes, and this association has recently been confirmed in a Japanese large‐scale female cohort, too. The risk might be further amplified by rapid catch‐up weight gain in childhood.…”

Diagnosis and surveillance of late-onset fetal growth restriction

“…Finally, it has been suggested that fetal programing also operates in term SGA babies, 18 predisposing them to a higher incidence of metabolic syndrome. Another recent large cohort study 19…”

“…Upon stratification, the association remained only significant for those cases (n ¼ 560) with EFW <10th centile (RR, 1.96; 95% CI, 1.21e3. 19). The effect of SGA on adverse outcome was significantly modified by the presence of low growth velocity, to a greater extent than by the presence of abnormal umbilical or uterine Doppler velocimetry.…”

Birth weight and risk of type 2 diabetes: A dose‐response meta‐analysis of cohort studies

“…After screening, 21 studies (19 cohort articles) entered the meta‐analysis (Table S2), including 1 041 879 individuals and 35 699 cases of T2DM. There were 12 studies in Europe, 5 in America, and 4 in Asia (Table ). Two studies focused on females and males; three studies only focused on males, and four studies only focused on females .…”