Fetal growth and impaired glucose tolerance in men and women

Phipps, Kathy R.; Barker, D. J. P.; Hales, C. N.; Fall, Caroline; Osmond, Clive; Clark, P.

doi:10.1007/bf00399954

Cited by 477 publications

(280 citation statements)

References 11 publications

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“…On the other hand, the same findings may reconcile this sequence with the more recent observation, that a low birthweight and a lower weight at 1 year predict IGT during the sixth decade of life [9][10][11]. Maternal hyperinsulinaemia is associated with low birthweight, and might represent the trait through which the genetic pressure towards diabetes is routed to the offspring.…”

Section: Discussionsupporting

confidence: 70%

Relation of birthweight to maternal plasma glucose and insulin concentrations during normal pregnancy

et al. 1993

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Summary.Maternal diabetes mellitus is complicated by fetal macrosomia and predisposes the offspring to diabetes, but recent evidence indicates that a low, not high, birthweight is associated with a higher incidence of Type 2 (non-insulin dependent) diabetes in adult life. To clarify the relationships between maternal glucose and insulin levels and birthweight, we measured oral glucose tolerance and neonatal weight in a large group (n = 529) of women during the 26th week of pregnancy. Women with gestational diabetes (n = 17) had more familial diabetes, higher pre-pregnancy body weight, and tended to have large-for-gestational-age babies. In contrast, women with essential hypertension (n = 10) gave birth to significantly (p < 0.01) smaller babies. In the normal group (without gestational diabetes or hypertension, n --503), maternal body weight before pregnancy and at term, maternal height, week of delivery, gender of the newborn, and parity were all significant, independent predictors of birthweight, together explaining 23 % of the variability of neonatal weight. In addition, both fasting (p < 0.006) and 2-h post-glucose (p = 0.03) maternal plasma glucose concentrations were positively associated with birthweight independent of the other physiological determinants, accounting, however, for only 10% of the explained variability. In a subgroup of 134 normal mothers with prepregnancy body mass index of less than 25 kg. m 2, in whom plasma insulin measurements were available, the insulin area-under-curve was inversely related to birthweight (p < 0.02) after simultaneously adjusting for physiological factors and glucose area. When glucose and insulin measurements were combined in the I/G ratio (ratio of insulin to glucose area), this was still inversely related to birthweight. Furthermore, maternal insulinaemia was directly related to blood pressure levels (p <0.001) independently of body weight. We conclude that in normal pregnancy, whereas physiological factors account for most of the explainable variability of infant weight, the influence of the maternal metabolic milieu is dual, positive for glucose levels but negative for insulin concentrations. Maternal hyperinsulinaemia during pregnancy may be one trait linking low birthweight with predisposition to diabetes in adult life.

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Section: Discussionsupporting

confidence: 70%

Relation of birthweight to maternal plasma glucose and insulin concentrations during normal pregnancy

et al. 1993

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“…In numerous populations throughout the world, decreased glucose tolerance in adulthood has been associated with low birth weight and thinness at birth (Hales et al, 1991;Phipps et al, 1993;McCance, 1994;Lithell et al, 1996;Fall, 2001a and2001b). A similar observation has been made in pigs by other authors (Poore and Fowden, 2002) but this did not appear to be the case for G1 pigs in the present study during the non-pregnant state.…”

Section: Discussionmentioning

confidence: 99%

Intergenerational effects of birth weight on glucose tolerance and reproductive performance

Corson

Laws

Litten

et al. 2009

Animal

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Women who were themselves small-for-gestational age (SGA) are at a greater risk of adulthood diseases such as non-insulindependent diabetes mellitus (NIDDM), and twice at risk of having an SGA baby themselves. The aim of this study was to examine the intergenerational pig. Low (L) and normal (N) birth weight female piglets were followed throughout their first pregnancy (generation 1 (G1)). After they had given birth, the growth and development of the lightest (l) and heaviest (n) female piglet from each litter were monitored until approximately 5 months of age (generation 2 (G2)). A glucose tolerance test (GTT) was conducted on G1 pig at , 6 months of age and again during late pregnancy; a GTT was also conducted on G2 pigs at , 4 months of age. G1 L offspring exhibited impaired glucose metabolism in later life compared to their G1 N sibling but in the next generation a similar scenario was only observed between l and n offspring born to G1 L mothers. Despite G1 L mothers showing greater glucose intolerance in late pregnancy and a decreased litter size, average piglet birth weight was reduced and there was also a large variation in litter weight; this suggests that they were, to some extent, prioritising their nutrient intake towards themselves rather than promoting their reproductive performance. There were numerous relationships between body shape at birth and glucose curve characteristics in later life, which can, to some extent, be used to predict neonatal outcome. In conclusion, intergenerational effects are partly seen in the pig. It is likely that some of the intergenerational influences may be masked due to the pig being a litter-bearing species.

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“…8 Pre-and postnatal events such as low birth weight or intrauterine growth retardation are thought to influence the health status of adolescents and youth; many population-based studies have reported that low birth weight is predictive of an increased risk for diseases in adulthood such as cardiovascular diseases, type 2 diabetes and hypertension. [9][10][11][12][13] The prevalence of type 2 diabetes has increased among children worldwide during the past decade. Hales, Barker and colleagues 10 hypothesized that low birth weight and reduced growth early in life are strongly linked with impaired glucose tolerance and noninsulin-dependent diabetes.…”

Section: Introductionmentioning

confidence: 99%

“…Hales, Barker and colleagues 10 hypothesized that low birth weight and reduced growth early in life are strongly linked with impaired glucose tolerance and noninsulin-dependent diabetes. 10,11 The association between low birth weight in girls and coronary heart disease is thought to reflect the persistence of changes in morphology and physiology that accompany slow fetal growth and seem to be independent of indices of living standards in childhood and adult life. 12,13 Reduced intrauterine growth is linked to high blood pressure (BP), which may explain the association between hypertension and impaired glucose tolerance.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic questionnaire and clinical assessment in the HELENA Cross-Sectional Study: methodology

et al. 2008

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Rationale: Environmental factors such as dietary habits, breastfeeding, socioeconomic conditions and educational factors are strong influences on nutritional and puberty status, physical activity, food choices and their interactions. Several diseases of adulthood seem to be linked to, or to originate from, lifestyle in childhood and adolescence. Objective: The aims of this study are to describe birth parameters and socioeconomic factors and to assess clinical status in adolescents aged 13-16 years from 10 European countries participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Cross-Sectional Study (CSS). Methodology: A self-report questionnaire on the socioeconomic status, a parental questionnaire concerning neonatal period and also a case report form (CRF), in which clinical items during clinical examination (such as medical history, treatments, anthropometry, Tanner staging, blood pressure, heart rate) were assessed. To develop these documents, first a list of items was established, a search of existing documents was performed and the advice of local and international experts was taken. All documents (questionnaires and an operations manual) were discussed in plenary HELENA meetings; a final version of these documents was fixed, and the process of translation and back translation was performed. Results:The questionnaires and CRF were tested for validation in all 10 participant cities; 208 adolescents were enrolled during the pilot study. All items that caused problems or questions in one or more participating centers or were completed by o 85% of the adolescents were reviewed before the beginning of the HELENA-CSS. Conclusion: These final questionnaires and CRF will contribute to better understanding of the inequalities in nutrition, behavior and health in the European adolescent population. The experience and process should be useful for other multicenter studies.

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Fetal growth and impaired glucose tolerance in men and women

Cited by 477 publications

References 11 publications

Relation of birthweight to maternal plasma glucose and insulin concentrations during normal pregnancy

Relation of birthweight to maternal plasma glucose and insulin concentrations during normal pregnancy

Intergenerational effects of birth weight on glucose tolerance and reproductive performance

Socioeconomic questionnaire and clinical assessment in the HELENA Cross-Sectional Study: methodology

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