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Low, high birth weight increase diabetes risk for Chinese adults
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For Chinese adults, being born with a weight of less than 2,500 g or at least 3,500 g can lead to a higher susceptibility to developing diabetes, according to findings published in the Journal of Diabetes.
“Numerous previous studies have investigated association between birth weight and risk of diabetes, but the association remains the subject of debate,” Yufang Bi, MD, PhD, of the Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases and the Shanghai Jiao Tong University School of Medicine in Shanghai, and colleagues wrote. “It is of great importance to evaluate the effects of lifestyle factors, in addition to birth weight, on the risk of [type 2 diabetes] in different populations.”
Bi and colleagues analyzed data from 49,118 adults (mean age, 55.83 years; 72.06% women) aged 40 to 80 years who took part in the REACTION study. Questionnaires provided information about demographics, medical history, physical activity and dietary intake. Participants also self-reported their birth weight. The researchers defined normal birth weight as between 2,500 g and 3,499 g.
In addition to the questionnaires, participants underwent a 75-g oral glucose tolerance test and provided blood samples to assess fasting plasma glucose, HbA1c, triglycerides and cholesterol. An HbA1c of at least 6.5%, an FPG measure of at least 126 mg/dL or 2-hour glucose of at least 200 mg/dL following the OGTT were among the confirming factors for diabetes, according to the researchers.
Birth weight and diabetes
Of the 1,116 participants with a birth weight of less than 2,500 g, there were 314 cases of diabetes (28.14%). Meanwhile, 23.95% of those with normal birth weight, 26.42% of those with a birth weight between 3,500 g and 3,999 g and 27.3% of those with a birth weight of at least 4,000 g developed diabetes. The researchers noted that in fully adjusted models, those with a low birth weight were 1.28 times more likely to develop diabetes compared with those with normal weight (OR = 1.28; 95% CI, 1.11-1.47). The risk was elevated by 1.11 times for those with a birth weight between 3,500 g and 3,999 g (OR = 1.11; 95% CI, 1.04-1.19) and by 1.2 times for those with a birth weight of at least 4,000 g (OR = 1.2; 95% CI, 1.07-1.34).
Diabetes development was more than twice as likely for participants of all birth weights if they had a BMI of at least 28 kg/m2 during the study. Participants with normal birth weight and a BMI of less than 24 kg/m2 had the lowest risk for developing diabetes with risk increased in comparison for those with a BMI of at least 28 kg/m2 and a birth weight of less than 2,500 g (OR = 2.34; 95% CI, 1.68-3.27), between 3,500 g and 3,999 g (OR = 2.53; 95% CI, 2.22-2.9) and at least 4,000 g (OR = 2.54; 95% CI, 2.02-3.19) as well as a normal birth weight (OR = 2.08; 95% CI, 1.95-2.22). The risk was also elevated for those with a present day BMI between 24 kg/m2 and 28 kg/m2 and low birth weight (OR = 2.19; 95% CI, 1.76-2.72), normal birth weight (OR = 1.47; 95% CI, 1.39-1.56), a birth weight of between 3,5000 g and 3,999 g (OR = 1.56; 95% CI, 1.4-1.74) and a birth weight of at least 4,000 g (OR = 1.84; 95% CI, 1.55-2.19) compared with those with a BMI of less than 24 kg/m2 and normal birth weight.
Influences of diet, physical activity, sex
The researchers further noted that failing to have a healthy diet or to exercise at a moderate level for at least 150 minutes per week or at a vigorous level for at least 75 minutes per week, which they termed “ideal physical activity,” affected the risk for diabetes among those with low birth weight and those with a birth weight between 3,500 g and 3,999 g. Participants with low birth weight who did not have a healthy diet were more likely to develop diabetes (OR = 1.42; 95% CI, 1.21-1.66) and those who did not have ideal physical activity were also more likely to develop the disease (OR = 1.26; 95% CI, 1.08-1.47), with both groups compared with those with normal birth weight and similar dietary and physical activity categorization. The connection between low birth weight and diabetes development lost its significance for those who had a healthy diet or ideal physical activity in addition to low birth weight. Similarly, those with an unhealthy diet (OR = 1.12; 95% CI, 1.04-1.21) and nonideal physical activity (OR = 1.11; 95% CI, 1.03-1.19) in addition to a birth weight of between 3,500 g and 3,999 g were more likely to develop diabetes, but the significance was lost for those who had a healthy diet or ideal physical activity.
Lastly, the researchers noted that women were more likely to develop diabetes if they had low birth weight (OR = 1.24; 95% CI, 1.06-1.46), a birth weight between 3,500 g and 3,999 g (OR = 1.14; 95% CI, 1.04-1.25) or a birth weight of at least 4,000 g (OR = 1.29; 95% CI, 1.11-1.48) compared with women with normal birth weight. Men of low birth weight were more at risk compared with men with normal birth weight (OR = 1.4; 95% CI, 1.04-1.89), but significance was not reached for those with birth weights of 3,5000 g or more.
“We found a U-shaped association between birth weight and the risk of diabetes after adjustment for covariates,” the researchers wrote. “Great importance should be attached to both abnormal birth weight and healthy lifestyle to maintain non-obesity in later life to prevent the development of diabetes.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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