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BMJ. 1991 Oct 26;303(6809):1019-22.

Fetal and infant growth and impaired glucose tolerance at age 64.

Author information

  • 1Department of Clinical Biochemistry, University of Cambridge, Addenbrooke's Hospital.

Abstract

OBJECTIVE:

To discover whether reduced fetal and infant growth is associated with non-insulin dependent diabetes and impaired glucose tolerance in adult life.

DESIGN:

Follow up study of men born during 1920-30 whose birth weights and weights at 1 year were known.

SETTING:

Hertfordshire, England.

SUBJECTS:

468 men born in east Hertfordshire and still living there.

MAIN OUTCOME MEASURES:

Fasting plasma glucose, insulin, proinsulin, and 32-33 split pro-insulin concentrations and plasma glucose and insulin concentrations 30 and 120 minutes after a 75 g glucose drink.

RESULTS:

93 men had impaired glucose tolerance or hitherto undiagnosed diabetes. They had had a lower mean birth weight and a lower weight at 1 year. The proportion of men with impaired glucose tolerance fell progressively from 26% (6/23) among those who had weighted 18 lb (8.16 kg) or less at 1 year to 13% (3/24) among those who had weighed 27 lb (12.25 kg) or more. Corresponding figures for diabetes were 17% (4/23) and nil (0/24). Plasma glucose concentrations at 30 and 120 minutes fell with increasing birth weight and weight at 1 year. Plasma 32-33 split proinsulin concentration fell with increasing weight at 1 year. All these trends were significant and independent of current body mass. Blood pressure was inversely related to birth weight and strongly related to plasma glucose and 32-33 split proinsulin concentrations.

CONCLUSIONS:

Reduced growth in early life is strongly linked with impaired glucose tolerance and non-insulin dependent diabetes. Reduced early growth is also related to a raised plasma concentration of 32-33 split proinsulin, which is interpreted as a sign of beta cell dysfunction. Reduced intrauterine growth is linked with high blood pressure, which may explain the association between hypertension and impaired glucose tolerance.

Comment in

PMID:
1954451
[PubMed - indexed for MEDLINE]
PMCID:
PMC1671766
Free PMC Article
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