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

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.

• Authors: C N Hales, D J Barker, P M Clark, L J Cox, C Fall, C Osmond, P D Winter
• Journal: BMJ (Clinical research ed.) (BMJ) Vol. 303 Issue 6809 Pg. 1019-22 (Oct 26 1991) ISSN: 0959-8138 [Print] England
• PMID: 1954451 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Insulin
• Proinsulin

Topics

• Aged
• Birth Weight (physiology)
• Blood Glucose (analysis)
• Blood Pressure (physiology)
• Body Mass Index
• Body Weight (physiology)
• Diabetes Mellitus, Type 2 (complications, diagnosis)
• Female
• Fetal Growth Retardation (complications)
• Glucose Tolerance Test
• Humans
• Insulin (blood)
• Male
• Middle Aged
• Pregnancy
• Proinsulin (blood)