Low birth weight plus overweight as young adults raises type 2 diabetes risk for men
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Key takeaways:
- Men with low birth weight plus overweight at age 20 years vs. normal weight at those timepoints are more likely to develop type 2 diabetes.
- Researchers said efforts to prevent diabetes must begin early in life.
Men who had a lower birth weight followed by overweight during young adulthood have a greatly increased risk for developing type 2 diabetes vs. those with normal weight at those times, according to study results published in Diabetologia.
“Significant risk for type 2 diabetes is already accumulated during the developmental period; and the fetal and pubertal periods, in this study represented by birth weight and young adult overweight, are the major developmental risk factors for type 2 diabetes,” Jimmy Célind, MD, PhD, researcher in the department of pediatrics, Institute of Clinical Studies, Sahlgrenska Academy at University of Gothenburg in Sweden, told Healio. “The combination of low birth weight and subsequent overweight in young adulthood was associated with a 10-fold increase of early type 2 diabetes in men, compared to men with birth weight of more than 2.5 kg and normal weight at young adulthood.”
Célind and colleagues obtained data from 34,231 men who participated in a population-based cohort study in Gothenburg, Sweden, and were born from 1945 to 1961. Birth weight and height and weight at about age 8 years and age 20 years were collected from national registries. BMI at age 8 years was estimated using paired height and weight measures from age 6.5 years to age 9.5 years, and BMI at age 20 years was estimated using paired height and weight measurements from age 17.5 years to age 22 years. Overweight at age 8 years was defined as a BMI of more than 17.9 kg/m2, and overweight at age 20 years was defined as a BMI of more than 25 kg/m2. Type 2 diabetes diagnoses were collected from the Swedish National Patient Register. Type 2 diabetes diagnoses at age 59.4 years or younger were defined as early type 2 diabetes, whereas any diagnoses after age 59.4 years were labeled as late type 2 diabetes. Follow-up began at age 30 years and continued until type 2 diabetes diagnosis, death, emigration or the end of follow-up on Dec. 31, 2019.
Lower birth weight and diabetes risk
There were 2,733 men diagnosed with type 2 diabetes during a median follow-up of 34.3 years. In a mutually adjusted model, participants who weighed less than 3.6 kg at birth had an increased risk for early type 2 diabetes (HR = 1.47; 95% CI, 1.32-1.63) and late type 2 diabetes (HR = 1.33; 95% CI, 1.19-1.48) compared with those who weighed 3.6 kg or more at birth. Men with overweight at age 20 years were more likely to develop early type 2 diabetes (HR = 3.99; 95% CI, 3.47-4.59) and late type 2 diabetes (HR = 2.3; 95% CI, 1.92-2.76) than men with normal weight. Overweight at age 8 years was not associated with an increased risk for type 2 diabetes.
Compared with participants with birth weight of 3.6 kg or higher and normal weight at age 20 years, those with birth weight of less than 3.6 kg and normal weight at age 20 years (HR = 1.48; 95% CI, 1.31-1.68), those with birth weight of 3.6 kg or higher and overweight (HR = 4.4; 95% CI, 3.66-5.29) and those with birth weight of less than 3.6 kg and overweight at age 20 years (HR = 6.07; 95% CI, 5.08-7.27) had an increased risk for early type 2 diabetes. An increased risk for late type 2 diabetes was also observed for participants with birth weight of less than 3.6 kg and normal weight at age 20 years (HR = 1.37; 95% CI, 1.22-1.53), those with birth weight of 3.6 kg or higher and overweight at age 20 years (HR = 2.63; 95% CI, 2.1-3.29) and those with birth weight of less than 3.6 kg and overweight at age 20 years (HR = 2.82; 95% CI, 2.19-3.62) compared with the normal birth weight and normal weight at age 20 years group.
Risk highest with low birth weight, overweight
In an explorative analysis where low birth weight was defined as 2.5 kg or lower, the risk for early type 2 diabetes was nearly 10 times higher for men with low birth weight and overweight at age 20 years compared with those with normal birth weight and normal young adult weight (HR = 9.94; 95% CI, 6.57-15.05). Participants with low birth weight and overweight at age 20 years also had an increased risk for late type 2 diabetes compared with those with normal weight at both birth and age 20 years (HR = 2.93; 95% CI, 1.22-7.04).
Célind said he was surprised to see how high the risk for early type 2 diabetes was for men with low birth weight plus overweight during young adulthood.
“The future societal burden of type 2 diabetes is massive, and it is diagnosed in increasingly younger ages, implicating increased exposure to preventable risk factors.” Célind said. “The clinical implications are that since a significant risk has been accumulated already in the developmental period, effective preventive efforts must start during development.”
Célind said similar studies need to be conducted among women, and studies are also needed to examine how the associations found in the study relate to BMI during older age.
For more information:
Jimmy Célind, MD, PhD, can be reached at jimmy.celind@gu.se.
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