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Low-birth-weight infants show earlier onset of IDDM
1Department of Endocrinology and Diabetes, Adelaide Children's Hospital, South Australia.
Insights
Infant growth and birth weight are linked to earlier onset of insulin-dependent diabetes mellitus (IDDM). These factors may influence pancreatic beta-cell mass, a key element in diabetes development.
Area of Science:
- Endocrinology
- Pediatrics
- Metabolic Disorders
Background:
- Pancreatic beta-cell mass undergoes rapid development during gestation and early infancy.
- Infants born small for gestational age often exhibit reduced beta-cell mass, indicating potential intrauterine growth restriction.
- Early life factors influencing beta-cell development are critical for understanding metabolic health trajectories.
Purpose of the Study:
- To investigate the relationship between early infancy growth parameters and the age of onset for insulin-dependent diabetes mellitus (IDDM).
- To explore whether birth weight, length, and growth in the first six months of life predict the timing of IDDM diagnosis.
- To assess the potential role of beta-cell mass, inferred from growth metrics, in the pathogenesis of early-onset IDDM.
Main Methods:
- Retrospective analysis of infant records from 232 patients diagnosed with IDDM.
- Data collected included birth weight, birth length, gestational age, and weight at 6 months of age.
- Feeding history during the first six months was also analyzed; maternal recall was not utilized.
Main Results:
- Low birth weight (<2.5 kg) was significantly associated with an earlier onset of IDDM (median 4.3 years vs. 9.0 years).
- Infants identified as small for gestational age, and those with low birth weight-to-length ratios or low 6-month weight, also showed earlier IDDM onset.
- Exclusive breastfeeding for six months correlated with a slightly later onset of diabetes compared to bottle or mixed feeding, independent of infant weight.
Conclusions:
- Prenatal and early postnatal growth parameters appear to influence the age at which insulin-dependent diabetes mellitus (IDDM) manifests.
- Beta-cell mass, potentially modulated by these early growth factors, is likely a significant determinant in the development of IDDM.
- These findings highlight the importance of monitoring infant growth as a potential indicator for future diabetes risk.
Objective:
Pancreatic beta-cell mass increases rapidly during gestation and early infancy. Infants who are small for gestational age, which is a marker for poor intrauterine nutrition, have reduced beta-cell mass. We examined whether weight and length in early infancy, and in inference beta-cell mass, is related to age at onset of insulin-dependent diabetes mellitus (IDDM).
Research Design And Methods:
Data from infant records of 232 patients with IDDM, including birth weight, birth length, gestational age, weight at 6 months of age, and feeding history during the first 6 months of life, were analyzed. Maternal recall was not used for data collection.
Results:
Low-birth-weight infants (<2.5 kg) showed a significantly earlier onset of diabetes (4.3 [3.2-6.0] years vs. 9.0 [5.3-11.8] years, median [25-75th percentile]; P < 0.0001). Infants small for gestational age also had earlier onset than those with birth weight above the 10th percentile after correction for gestational age (6.2 [3.6-10.5] vs. 9.2 [5.4-11.8] years; P < 0.0001). Infants with corrected birth weight: length ratio below the 10th percentile had earlier onset, as did infants with corrected 6-months weight below the 10th percentile (4.9 [2.8-6.0] years vs. 8.8 [5.2-11.8] years; P < 0.0001). Infants who were exclusively breast-fed for 6 months showed a slightly later onset of diabetes than those who were bottle- or mixed-fed, independent of weight (9.4 [5.0-11.3] years vs. 8.3 [4.2-11.7] years; P < 0.0001).
Conclusions:
Weight and growth parameters in utero and early infancy may influence the age at onset of IDDM. beta-cell mass is likely to be a significant factor.