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Childhood BMI, length at birth affect risk for type 2 diabetes
Adults with a low BMI at birth but high childhood BMI have increased odds of developing type 2 diabetes, as do adults with both a low BMI and short length at birth, even when they have a low childhood BMI, according to research in the Journal of Internal Medicine.
Johan G. Eriksson, MD, DMSc, of the department of chronic disease prevention at the University of Helsinki, and colleagues analyzed data from 13,345 adults born between 1934 and 1944 and participating in the Helsinki Birth Cohort Study, whose growth was recorded in detail during childhood. Within the cohort, 1,558 were diagnosed with type 2 diabetes.
Johan G. Eriksson
Researchers divided the study cohort into two groups according to whether their BMI at 11 years was above or below the median value, and then assessed body composition and glucose tolerance in a clinical subsample in 2003.
Among participants with a BMI at 11 years above the median value, the cumulative incidence of diabetes was 15.7% in men and 10.3% in women. Among adults with a BMI below the median at 11 years, the incidence rate was 13.2% for men and 7.9% for women. The OR for diabetes among men with a BMI above the median at 11 years was 1.23 (95% CI, 1.05-1.44) and 1.35 for women (95% CI, 1.1-1.65).
In individuals with a BMI at 11 years that was below the median value, diabetes was associated with lower weight, shorter length and lower BMI at birth, the researchers said.
Length of gestation was not associated with diabetes in either BMI group, according to researchers.
“In one phenotype, which corresponds to the classical Western stereotype of type 2 diabetes, individuals tend to have a high BMI in adulthood,” the researchers wrote. “In the other, which is seen in clinical practice in Western countries but is more common in India and China, individuals tend to be less obese but nevertheless develop diabetes. Both trajectories started with a small body size at birth.”
Researchers noted that the second phenotype, which was not related to BMI in childhood, was more common among women.
“These findings suggest that diabetes may develop as a result of modest fat accretion in adulthood and may be associated with impaired insulin secretion due to prenatal experiences,” the researchers wrote.
They said optimizing the health of women of childbearing age, as well as childhood growth, is important to prevent type 2 diabetes in later life. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.