BIRTH CHARACTERISTIC AND IMPAIRED GLUCOSE TOLERANCE DURING ADULTHOOD

Mi J, Law C, Zhang KL, Osmond C, Zeng XJ, Barker DJP

Dept Epidemiology, Capital Institute of Pediatrics, Beijing, China

Objective: To explore the relationship between small body size at birth and impaired glucose tolerance (IGT) during adulthood in China.

Methods: 309 men and 319 women, being singletons born at the Peking Union Medical College Hospital (PUMCH) in Beijing between 1948 and 1954, were traced and attended a clinic, during which anthropometry and standard oral glucose tolerance test (OGTT) were carried out. Plasma insulin levels were measured with radioimmunoassay for them.

Results: 27 and 121 subjects were diagnosed as type 2 diabetes and IGT, respectively according to the criteria suggested by WHO. Prevalence of IGT (including type 2 diabetes) decreased with the increase in their birth weight (BW), Ponderal Index (PI) and head circumference (HC) at birth (trend test, BW:X²=6.7,P=0.01; PI:X²=4.8,P=0.03; HC:X²=5.8,P=0.02), with the highest of 43.8% in those with thin body size (PI<24 g/m³) at birth and obesity (body mass index, BMI>75 percentile) during adulthood, and the lowest of 8.3% in those with more fat at birth (PI³28g/m³) and keeping relatively thin (BMI<25 percentile) during adulthood. In addition, BW, PI and HC at birth correlated reversely with their plasma insulin levels fasting and two hours after sugar load during their adulthood. The relationship of body size at birth to the presence of type 2 diabetes and IGT, plasma insulin levels were independent of gestation, adult BMI and adult lifestyle factors, such as alcohol consumption, smoking, occupation and household income.

Conclusion: The finding of this study suggested that part of the risk of type 2 diabetes and IGT was programmed in fetal life. Prevalence of type 2 diabetes and IGT depended on the synergic effect of thin body size at birth and obesity during adulthood in this population.

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