Early life factors and Type 2 diabetes in south India: Do the associations change with age?

Abstract

Background: Studies since the early 1990s have shown that birth size can be a predictor of the development of Type 2 diabetes mellitus (T2DM). In the present study, we evaluated changes in the strength of associations between T2DM and birth size and maternal weight with age. Methods: In 1993–1994 (t0), 509 men and women (mean age 46 years) who had been born in Holdsworth Memorial Hospital were screened for diabetes, with increased diabetes risk identified in those who were shorter at birth and those born to heavier mothers. Ten years later (t10), the screening was repeated in 266 subjects who were non‐diabetic at t0 (70% of survivors). Results: At t10, 56 new cases of diabetes were found. The incidence of diabetes decreased with increasing birth length (odds ratio (OR) = 0.90, 95% confidence interval (CI) 0.84–0.97/cm birth length; P = 0.006) after adjustment for sex, age, socioeconomic status, family history, and current body mass index. Overall, there were no significant differences in OR for the association between birth length and diabetes at t0 compared with t10, but limiting analysis to subjects with normal glucose tolerance at t0 resulted in a stronger association at t10 (OR = 0.71, 95% CI 0.58–0.87) than at t0 (OR = 0.95, 95% CI 0.86–1.05; P = 0.015 for the difference). There was a positive correlation between maternal weight and incident disease at t0 (OR = 1.08, 95% CI 1.03–1.14; P = 0.001), but not at t10 (OR = 0.98/kg, 95% CI 0.92–1.05; P = 0.6; P = 0.02 for the difference). Conclusions: Short birth length remains a risk factor for diabetes. Changes in the effects of birth length and maternal weight on diabetes risk with age may indicate different causal pathways. These findings require replication in studies with more accurate dating of the onset of diabetes.

Environmental monitoring and the developmental origins of health and disease

“…Nevertheless, in case of migration of these populations to urban areas, with greater food availability, the risk of developing obesity and T2D increases significantly. 26 The possibility of eating higher-calorie diets during the postnatal life is a strong predictor of obesity and MetS. 27 The literature shows that not only poor perinatal nutrition but also a large caloric intake may expose the individual to a greater propensity of future metabolic diseases, suggesting that an unbalance in early nutrition, by poor or excessive feeding, may increase the susceptibility to future MetS.…”

Cohort Profile: The 1934–66 Mysore Birth Records Cohort in South India

“…whether smaller size at birth was associated with higher incident diabetes and CHD, 10 years after the initial study, n = 383, 2003–04; 16 …”

“…Pulse wave velocity was measured by a non-invasive optical method using the principle of photoplesythmography, to estimate arterial compliance (data set 3 from Table1); 383 of those who were examined in the first study in 1993–95 were followed up at 10 years (between 2003 and 2004, aged 50–70 years) to assess incident diabetes and CHD (data set 4 from Box 1 ). 16 A blood sample for DNA was collected from 551 participants.…”

“… 13–15 At the 10-year follow-up, shorter birth length remained a risk factor for incident type 2 diabetes, whereas higher maternal weight and larger maternal pelvic diameters showed no association with incident disease. 16 …”

Birth size, risk factors across life and cognition in late life: protocol of prospective longitudinal follow-up of the MYNAH (MYsore studies of Natal effects on Ageing and Health) cohort

“… 25 26 Ten years after the first study, 383 participated in a follow-up study for incident diabetes and metabolic syndrome between 2003 and 2004. 27 …”