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Birth weight as a predictor of type 2 diabetes mellitus: the U-shaped curve
1Sansum Medical Research Institute, 2219 Bath Street, Santa Barbara, CA 93105, USA. dpettitt@sansum.org
Insights
Birth weight and stature influence type 2 diabetes risk differently across populations. Environmental factors, both in utero and postnatally, likely explain these varied associations with gestational diabetes.
Area of Science:
- Reproductive health
- Metabolic disorders
- Epidemiology
Background:
- Birth weight is increasingly recognized as a potential predictor for type 2 diabetes mellitus.
- Existing research shows conflicting associations between birth size and diabetes risk in different populations.
- Gestational diabetes prevalence and its relationship with birth characteristics vary significantly across ethnic groups.
Purpose of the Study:
- To explore the complex and often disparate associations between birth weight, stature, and diabetes risk.
- To investigate potential environmental influences (in utero and postnatal) contributing to these variations.
- To examine if a U-shaped curve model explains the relationship between birth characteristics and diabetes in diverse populations.
Main Methods:
- Review of recent epidemiological findings on birth weight and type 2 diabetes mellitus.
- Analysis of population-specific data, including Pima Indians and California Latina women.
- Comparative assessment of associations between birth size/stature and gestational diabetes prevalence/glucose concentrations.
Main Results:
- Some populations exhibit an inverse relationship between birth size and diabetes.
- Pima Indians show a U-shaped association, with both high and low birth weights linked to higher diabetes rates.
- California Latina women demonstrate a positive association between stature and glucose concentration in gestational diabetes.
Conclusions:
- Disparate findings on birth weight and stature as diabetes predictors suggest population-specific environmental influences.
- Environmental factors during gestation and early life may modulate the impact of birth characteristics on diabetes risk.
- Further research is needed to elucidate the mechanisms behind these population-level variations.
Abstract:
Recent findings have sparked intense interest in birth weight as a predictor of type 2 diabetes mellitus. In some populations, there is an inverse association between birth size and disease; however, in the Pima Indians, a population with very high rates of gestational diabetes, high birth weight and low birth weight are associated with diabetes. This results in a U-shaped curve with higher diabetes rates in both tails of the distribution. Similarly, there are reports of an inverse association between stature and prevalence of gestational diabetes, but, in California Latina women with gestational diabetes, there is a positive association between stature and glucose concentration. Could these disparate findings also represent the two ends of a U-shaped curve? The disparities are likely due to differences in the environment, both in utero and postnatally, that different groups experience.