Among a cohort of Scottish adults with type 2 diabetes, those who were born with a weight below 2.893 kg developed diabetes earlier and at a lower BMI than those with a birth weight above 3.572 kg, according to findings presented at the European Association for the Study of Diabetes annual meeting.
“For the first time we have shown that, in those who develop type 2 diabetes, lower birth weight is associated with a younger age of diagnosis with a lower BMI and higher HDL cholesterol at diagnosis,” Christian Paulina, a medical student from the University of Dundee in in the U.K., told Endocrine Today. “These results imply that low birth weight may be associated with a more severe phenotype of type 2 diabetes probably characterized by reduced pancreatic insulin secretion.
Paulina and colleagues collected data on age, BMI, creatinine level, HDL cholesterol, triglycerides, serum alanine aminotransferase and systolic blood pressure at diabetes diagnosis for 48,000 people born between 1952 and 1966 using data from the Walker Birth Cohort and the national diabetes registry in Scotland. Data on birth weight were also collected.
Among a cohort of Scottish adults with type 2 diabetes, those who were born with a weight below 2.893 kg developed diabetes earlier and at a lower BMI than those with a birth weight above 3.572 kg.
The researchers found that diabetes was diagnosed at age 50 years on average (95% CI, 49.4-50.7) for those with a birth weight of less than 2.893 kg and at 51.3 years on average (95% CI, 50.7-51.9) for those with a birth weight of more than 3.572 kg.
The lower birthweight cohort also had a mean BMI of 34.2 kg/m2 (95% CI, 33.4-35) and mean HDL cholesterol of 1.13 mmol/L (95% CI, 1.097-1.163) at diagnosis vs. mean BMI of 35.8 kg/m2 (95% CI, 35-36.6) and mean HDL cholesterol of 1.09 mmol/L (95% CI, 1.059-1.121) for those with the higher birth weight.
According to the researchers, univariate regression analysis revealed that the average age at which diabetes would be diagnosed rose by 0.8 years for every 1 kg increase in birth weight. In addition, the researchers noted that when diabetes was diagnosed, BMI was 1.3 kg/m2 higher and HDL cholesterol was 0.04 mmol/L lower for every 1 kg increase in birth weight.
“It has long been established that being born with low birth weight is associated with increased risk of diabetes and cardiovascular disease in later life. This probably reflects a combination of genetics and intrauterine environment,” Paulina said. “We show that this increased risk for diabetes translates into a younger age of onset of diabetes and therefore greater lifetime risk.”
Clinical implications for these findings are not readily apparent, according to Paulina, but they could reinforce the importance of a healthy fetal environment.
“Our findings are largely of interest mechanistically and are based upon observations in many thousands of individuals. It would be hard to apply these results to an individual,” Paulina said. “However, it may be reasonable to extrapolate our findings to suggest that improving birth weight — by, for example, reducing maternal smoking or improving maternal nutrition in developing countries — will reduce diabetes risk and result in later-onset diabetes in those who develop diabetes; but further studies would need to be done in this area.” – by Phil Neuffer
Paulina C, et al Abstract 333. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 16-20, 2019; Barcelona, Spain.
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