BMJ 2002;325:359 ( 17 August )

Papers

Birth weight of offspring and insulin resistance in late adulthood: cross sectional survey

Debbie A Lawlor, MRC research training fellow,  George Davey Smith, professor of clinical epidemiology,  Shah Ebrahim, professor of epidemiology of ageing. 

Department of Social Medicine, University of Bristol, Bristol BS8 2PR

Correspondence to: D A Lawlor d.a.lawlor{at}bristol.ac.uk

Objective: To investigate the association between birth weight of offspring and mothers' insulin resistance in late adulthood.
Design: Cross sectional survey.
Setting: General practitioner's surgeries in 23 towns in Great Britain.
Participants: 4286 women aged 60-79 years.
Main outcome measures: Maternal insulin resistance.
Results: Birth weight of offspring was inversely related to maternal insulin resistance in late adulthood. For each 1 kg higher birth weight of offspring, women had a 15% reduction in the odds of being in the fourth with highest insulin resistance, compared to other fourths (odds ratio 0.85; 95% confidence interval 0.71 to 1.00). This increased to 27% (0.73; 0.60 to 0.90) after adjusting data for potential confounders. A U shaped relation between birth weight of offspring and diabetes in older age was found; women with the lightest and heaviest offspring had the highest prevalence of diabetes.
Conclusions: Birth weight of offspring is inversely related to the mother's insulin resistance in late adulthood, despite the association of glucose intolerance during pregnancy with heavier offspring at birth. Common genetic factors contribute to the relation between birth weight and risk of cardiovascular disease and diabetes in adults.

What is already known on this topic Small birth weight is related to increased risk of cardiovascular disease and diabetes in adulthood; the underlying mechanisms are unclear Small birth weight of offspring is related to parental cardiovascular disease, suggesting that common genetic factors affect birth weight and the risk of disease in adulthood Genetic factors associated with the metabolism of insulin are plausible in linking birth weight and cardiovascular disease (the fetal insulin hypothesis) What this study adds Birth weight of offspring is inversely related to maternal insulin resistance in older age Genetic factors related to both insulin resistance and birth weight explain at least part of the association between birth weight and risk of cardiovascular disease and diabetes in adulthood

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Rapid Responses:

Read all Rapid Responses

Hyperinsulinemia-Insulin Resistance is now-a-days a "clinical" Diagnosis.

Sergio Stagnaro
bmj.com, 16 Aug 2002 [Full text]

Low DHEA May Explain These Findings

James M. Howard
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The "U shaped Relationship" is due to loss of DHEA

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bmj.com, 19 Aug 2002 [Full text]

Transfer of Disease from unborn child to mother

Anita Banerjee
bmj.com, 20 Aug 2002 [Full text]

Re: Transfer of Disease from unborn child to mother

James M. Howard
bmj.com, 21 Aug 2002 [Full text]

Transgenerational link with maternal insulin resistance may not be 'genetic'

Henry S Kahn
bmj.com, 22 Aug 2002 [Full text]

Re: Re: Transfer of Disease from unborn child to mother

Anita Banerjee
bmj.com, 23 Aug 2002 [Full text]

Re: Transgenerational link with maternal insulin resistance may not be 'genetic'

James M. Howard
bmj.com, 26 Aug 2002 [Full text]

Re: Re: Transgenerational link with maternal insulin resistance may not be 'genetic'

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Authors' reply: Trans-generational associations are present for fathers and mothers

Debbie A Lawlor, et al.
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Authors' reply to Yajnik et al.

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