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Low birth weight among adults with a family history of diabetes decreases the risk of metabolic syndrome

      Objective

      Having a low weight at birth (LBW) or macrosomic weight (MBW) have been linked to cardiovascular risk factors and type 2 diabetes (T2D) later in life. We hypothesized that the risk of obesity, hypertension (HTN), the metabolic syndrome (MS), and T2D would be increased in subjects who weighed <2500g (LBW) or 4000g (MBW) at birth and had a first-degree relative with T2D.

      Study design

      We performed a cross sectional analysis on 1148 mother-child pairs who participated in the GENetics of Non-Insulin dependent Diabetes (GENNID) to compare the frequencies of the MS and T2D in adult offspring with reported LBW (n=120) or MBW (n=122) compared to normal BW (NBW: n=906). The MS was defined by the revised National Cholesterol Education Program Adult Treatment Panel III. T2D was determined by medical history or fasting and 2 hour glucose values.

      Results

      The groups had similar age (mean±SE: LBW 45.2±1.12 vs NBW 44.2±0.39 vs MBW 43.4±1.07 years,p=0.5), sex distribution (female: 63 vs 59 vs 56%, p=0.6) and smoking status (48 vs 49 vs 57%, p=0.1). LBW subjects were more likely to be African American (25 vs 14 vs 9%, p=0.001). Adjusting for age, sex, smoking, and race, LBW were less obese than NBW (BMI 28.4±0.64 vs 31.3±0.28 kg/m2, p<0.0001 and had lower waist circumference 92±2 cm vs 101±1 cm, p<0.0001), whereas MBW had higher BMI (33.6±0.87 vs 31.4±0.28 kg/m2, p=0.02) and a trend to higher waist circumference (105±2 vs 101±1 cm, p=0.09). LBW also had lower blood pressures (systolic 119±2 vs. 123±1 mmHg, p=0.006) and insulin levels (13.9±1.3 vs 17.6±0.7 ìU/ml, p=0.007). Consistent with this, LBW had a decreased risk of the MS (LBW 58 vs NBW 70%, OR .54, 95% CI .30-.95, p=0.03). However, the risk of T2D was not different (LBW 61 vs NBW 60 vs MBW 60%, p=0.9).

      Conclusion

      Among individuals with a family history of T2D, having LBW decreased the risk of obesity, central adiposity, HTN, and the MS later in life. Thus, in this high-risk population, LBW appears protective for future metabolic risk; whereas MBW did not confer additional risk of MS or T2D over NBW.