Birthweight and adult health outcomes in a biethnic population in the USA

Abstract

Recent data indicate that low-birthweight adults are at a higher risk than their high-birthweight peers of developing ischaemic heart disease or a cluster of conditions known as the IRS, which includes dys-lipidaemias, hypertension, unfavourable body fat distribution and NIDDM. Thus far these observations have been limited to Caucasians from the United Kingdom. We extended these observations to a broader segment of the general population by studying the association of birthweight and adult health outcomes in a biethnic population of the United States. We divided a group of 564 young adult Mexican-American and non-Hispanic white men and women participants of the S an Antonio Heart Study into tertiles of birthweight and compared metabolic, anthropometric, haemodynamic, and demographic characteristics across these tertile categories. Additionally, we studied birthweight as a pre-dictor of the clustering of diseases associated with the IRS, defined as any two or more of the following conditions: hypertension, NIDDM or impaired glucose tolerance, dyslipidaemia. Normotensive, non-diabetic individuals whose birthweight was in the lowest tertile had significantly higher levels of fasting serum insulin and a more truncal fat deposition pattern than individuals whose birthweight was in the highest tertile, independently of sex, ethnicity, and current socioeconomic status. Also, the odds of expressing the IRS increased 1.72 times (95% confidence interval: 1.16-2.55) for each tertile decrease in birthweight. These findings were independent of sex, ethnicity, and current levels of socioeconomic status or obesity. In conclusion, low birthweight could be a major independent risk factor for the development of adult chronic conditions commonly associated with insulin resistance in the general population. [Diabetologia (1994) 37: 624-631]

Born Small for Gestational Age: Increased Risk of Type 2 Diabetes, Hypertension and Hyperlipidaemia in Adulthood

“…This association was independent of current body weight or gestational age at birth. This observation was confirmed in a study population composed of Hispanic and non-Hispanic white subjects aged 30 years and over [9]. In this study population, the relative risk for developing syndrome X increased 1.72 times for each tertile decrease in birth weight.…”

“…Nevertheless it should be noted that this association is sharply amplified by obesity [4, 9]or a family history of type 2 diabetes [10, 11]. Thus, reduced fetal growth should be considered a contributing factor whereas the other known risk factors are unequivocal.…”

Small for Gestational Age and the Metabolic Syndrome: Which Mechanism Is Suggested by Epidemiological and Clinical Studies?

“…This association was independent of current body weight and gestational age. In a study population composed of Hispanic and non-Hispanic Caucasian individuals aged 30 years or more, relative risk for the development of the insulin-resistance syndrome increased 1.72 times for each tertile decrease in birth weight [21]. …”

Nutrition, Glucocorticoids and Pancreas Development

“…Several reports support the hypothesis that this association involves insulin resistance before the development of the metabolic syndrome. This has been observed in 60- to 70-year-old adults [1,2,3,4]; however, it has also been seen in a cohort of young adults (25 years of age) [5, 6]. Those individuals who suffered intrauterine growth retardation (IUGR) demonstrated hyperinsulinaemia and insulin resistance, with normal glucose tolerance.…”