Article

Diabetologia

, Volume 55, Issue 12, pp 3204-3212

Adult glucose metabolism in extremely birthweight-discordant monozygotic twins

  • M. FrostAffiliated withThe Danish Twin Registry, Department of Epidemiology, University of Southern DenmarkDepartment of Endocrinology and Metabolism, Odense University Hospital Email author 
  • , I. PetersenAffiliated withThe Danish Twin Registry, Department of Epidemiology, University of Southern Denmark
  • , K. BrixenAffiliated withDepartment of Endocrinology and Metabolism, Odense University Hospital
  • , H. Beck-NielsenAffiliated withDepartment of Endocrinology and Metabolism, Odense University Hospital
  • , J. J. HolstAffiliated withNovoNordisk Foundation Center for Basic Metabolic Research, Department of Biomedical Sciences, The Panum Institute, University of Copenhagen
  • , L. ChristiansenAffiliated withThe Danish Twin Registry, Department of Epidemiology, University of Southern Denmark
  • , K. HøjlundAffiliated withDepartment of Endocrinology and Metabolism, Odense University Hospital
  • , K. ChristensenAffiliated withThe Danish Twin Registry, Department of Epidemiology, University of Southern DenmarkDepartment of Clinical Biochemistry and Pharmacology, Odense University HospitalDepartment of Clinical Genetics, Odense University Hospital

Abstract

Aims/hypothesis

Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment.

Methods

Among 77,885 twins in the Danish Twin Registry, 155 of the most BW-discordant MZ twin pairs (median BW difference 0.5 kg) were assessed using a 2 h oral glucose tolerance test with sampling of plasma (p-)glucose, insulin, C-peptide, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. HOMA for beta cell function (HOMA-β) and insulin resistance (HOMA-IR), and also insulin sensitivity index (BIGTT-SI) and acute insulin response (BIGTT-AIR), were calculated. Subgroup analyses were performed in those with: (1) double verification of BW difference; (2) difference in BW >0.5 kg; and (3) no overt metabolic disease (type 2 diabetes, hyperlipidaemia or thyroid disease).

Results

No intra-pair differences in p-glucose, insulin, C-peptide, incretin hormones, HOMA-β, HOMA-IR or BIGTT-SI were identified. p-Glucose at 120 min was higher in the twins with the highest BW without metabolic disease, and BIGTT-AIR was higher in those with the highest BW although not in pairs with a BW difference of >0.5 kg.

Conclusions/interpretation

BW-discordant MZ twins provide no evidence for a detrimental effect of low BW on glucose metabolism in adulthood once genetic factors and rearing environment are controlled for.

Keywords

Birthweight Fetal programming Incretin hormones Oral glucose tolerance test Twins Type 2 diabetes