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Thinness at birth and glucose tolerance in seven-year-old children
C M Law1, G S Gordon, A W Shiell
1MRC Environmental Epidemiology Unit, Southampton General Hospital, UK.
Insights
Thinness at birth, indicated by a low ponderal index, is linked to impaired glucose tolerance in children. This suggests that the origins of Type 2 diabetes may begin during fetal development.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Health
Background:
- Low birth weight and thinness at birth are associated with increased risks of Type 2 diabetes and impaired glucose tolerance in adults.
- Understanding early life factors influencing metabolic health is crucial for preventing chronic diseases.
Purpose of the Study:
- To investigate the association between thinness at birth and glucose tolerance in children.
- To determine if early-life anthropometric measurements predict later metabolic dysfunction.
Main Methods:
- A cohort of 250 7-year-old children participated in an abbreviated oral glucose tolerance test.
- Ponderal index (birthweight/length^3) was used as a measure of thinness at birth.
- Plasma glucose concentrations were measured at 30 minutes post-glucose load.
Main Results:
- Children thin at birth (low ponderal index) exhibited higher plasma glucose concentrations.
- A significant positive correlation was found between lower ponderal index and elevated 30-minute plasma glucose levels (p=0.04).
- These findings remained consistent regardless of gestational age, gender, social class, or current weight.
Conclusions:
- Thinness at birth is associated with reduced glucose tolerance in childhood.
- The results support the hypothesis that Type 2 diabetes may have origins in the intrauterine environment.
- Early life factors, including birth anthropometry, are important determinants of long-term metabolic health.
Abstract:
Adults who had low birthweight and were thin at birth have an increased risk of Type 2 diabetes and impaired glucose tolerance. To discover whether thinness at birth is associated with reduced glucose tolerance in children, 250 7-year-old children underwent an abbreviated oral glucose tolerance test. Children who were thin at birth, as measured by a low ponderal index (birthweight length-3) had higher plasma glucose concentrations. Plasma glucose concentration 30 min after a glucose load rose by 0.07 mmol l-1 (95% confidence interval 0.00 to 0.14; p = 0.04) for every unit (kg m-3) fall in ponderal index. Children in the lowest quarter of the distribution of ponderal index (23 kg m-3 or less) had a mean 30 min plasma glucose concentration of 8.49 mmol l-1 compared to a mean of 7.97 mmol l-1 for those in the highest quarter (> 27.5 kg m-3). These associations were independent of duration of gestation, gender, social class or the child's current weight. This is consistent with the hypothesis that Type 2 diabetes originates in utero.