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Abnormal liver growth in utero and death from coronary heart disease

BMJ 1995; 310 doi: (Published 18 March 1995) Cite this as: BMJ 1995;310:703
  1. D J P Barker, directora,
  2. C N Martyn, clinical scientista,
  3. C Osmond, statisticiana,
  4. G A Wield, systems analysta
  1. a MRC Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital, Southampton SO16 6YD
  1. Correspondence to: Professor Barker.
  • Accepted 21 February 1995

Evidence is growing that the metabolic abnormalities which lead to coronary heart disease are programmed by undernutrition in utero. Undernutrition of the fetus leads to small size and disproportionate body form at birth, which are now known to be linked to metabolic abnormalities in later life.1 Abdominal circumference may be measured routinely at birth and indicates liver growth in utero as well as the fatness of the abdominal wall. A recent study showed that men who had a small abdominal circumference at birth had raised serum concentrations of total and low density lipoprotein cholesterol.2 They also had raised plasma concentrations of fibrinogen, another major risk factor for coronary heart disease that is regulated by the liver.3 These associations were independent of social class, current body weight, cigarette smoking, and alcohol consumption. They suggest that impaired …

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