Lower birth weight tied to type 2 diabetes at younger age, lower BMI
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Having a lower birth weight is associated with type 2 diabetes onset at a younger age, and those with a lower birth weight are also more likely to have a lower BMI at diagnosis, according to study findings published in Diabetic Medicine.
“The associations between birth weight with the age at diagnosis and the BMI at diagnosis remained after adjustment for confounding variables,” Ewan R. Pearson, FRCP, PhD, professor of diabetic medicine and head of the division of population health and genomics at the University of Dundee School of Medicine, U.K., and colleagues wrote. “The finding that patients with low birth weight who develop diabetes young have lower BMI suggests that this association is mediated via reduced beta-cell function, as the lower BMI and higher HDL are markers of insulin sensitivity.”
Researchers collected data from the Walker Birth Cohort of people born in Dundee, Scotland, from 1952 to 1966. Individuals diagnosed with type 2 diabetes who were residents in the National Health Service (NHS) Tayside region from 1995 to March 2017 or the NHS Fife region from 2010 to March 2017 were included in the study. Birth weight, gestation, complications and placental weight were collected from the birth cohort. Information on diabetes diagnosis, diabetes type, BMI and blood pressure were obtained from the Scottish Care Information – Diabetes Collaboration. HbA1c, HDL cholesterol, creatinine and alanine transaminase levels were collected from laboratory records.
The study cohort included 1,509 people with type 2 diabetes who had an adjusted birth weight available. Men had a higher mean birth weight compared with women (3.262 kg vs. 3.151 kg; P < .001).
In multiple regression analysis, each 1 kg reduction in birth weight was associated with a younger age of 0.87 years (95% CI, 0.26-1.4; P = .005) and a 1.49 kg/m2 lower BMI (95% CI, 0.77-2.2; P < .0001) at type 2 diabetes diagnosis.
Of the study cohort, 29.1% progressed to insulin treatment during a median follow-up time of 5.39 years. Each 1-year increase in the age of type 2 diabetes diagnosis was associated with a 1.9% lower risk of needing insulin (HR = 0.98; 95% CI, 0.96-0.99; P = .038), and men had a 33% lower risk of needing insulin compared with women (HR = 0.67; 95% CI, 0.53-0.84; P < .001). Birth weight was not associated with the likelihood of needing insulin therapy.
The researchers wrote that more studies are needed to explore the mechanisms behind the association between low birth weight and age at type 2 diabetes onset.
“Further studies, including the measurement of beta-cell function and insulin resistance at diagnosis, are warranted, and genetic studies linking birth weight to the age of diabetes onset will be of value in determining the contribution of fetal genetics to the intrauterine environment to this association,” the researchers wrote.
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