Diabetologia

, Volume 36, Issue 3, pp 225–228 | Cite as

Fetal growth and impaired glucose tolerance in men and women

  • K. Phipps
  • D. J. P. Barker
  • C. N. Hales
  • C. H. D. Fall
  • C. Osmond
  • P. M. S. Clark
Originals

Summary

A follow-up study was carried out to determine whether reduced fetal growth is associated with the development of impaired glucose tolerance in men and women aged 50 years. Standard oral glucose tolerance tests were carried out on 140 men and 126 women born in Preston (Lancashire, UK) between 1935 and 1943, whose size at birth had been measured in detail. Those subjects found to have impaired glucose tolerance or non-insulin-dependent diabetes mellitus had lower birthweight, a smaller head circumference and were thinner at birth. They also had a higher ratio of placental weight to birthweight. The prevalence of impaired glucose tolerance or diabetes fell from 27% in subjects who weighed 2.50 kg (5.5 pounds) or less at birth to 6% in those who weighed more than 3.41 kg (7.5 pounds) (p < 0.002 after adjusting for body mass index). Plasma glucose concentrations taken at 2-h in the glucose tolerance test fell progressively as birthweight increased (p < 0.004), as did 2-h plasma insulin concentrations (p < 0.001). The trends with birthweight were independent of duration of gestation and must therefore be related to reduced rates of fetal growth. These findings confirm the association between impaired glucose tolerance in adult life and low birthweight previously reported in Hertfordshire (UK), and demonstrate it in women as well as men. It is suggested that the association reflects the long-term effects of reduced growth of the endocrine pancreas and other tissues in utero. This may be a consequence of maternal undernutrition.

Key words

Impaired glucose tolerance non-insulin-dependent diabetes mellitus fetal growth ponderal index at birth placental weight to birthweight ratio 

References

  1. 1.
    Hales CN, Barker DJP, Clark PMS et al. (1991) Fetal and infant growth and impaired glucose tolerance at age 64 years. Br Med J 303: 1019–1022Google Scholar
  2. 2.
    Barker DJP, Bull AR, Osmond C, Simmonds SJ (1990) Fetal and placental size and risk of hypertension in adult life. Br Med J 301: 259–262Google Scholar
  3. 3.
    Kunst A, Draeger B, Ziegenhorn J (1983) UV-methods with hexokinase and glucose-6-phosphate dehydrogenase. In: Bergmeyer HU (ed) Methods of enzymatic analysis, Vol VI. Weinheim: Verlag Chemie, Deerfield, pp 163–172Google Scholar
  4. 4.
    Sobey WJ, Beer SF, Carrington CA et al. (1989) Sensitive and specific two-site immuno-radiometric assays for human insulin, proinsulin, 65–66 split and 32–33 split proinsulins. Biochem J 260: 535–541PubMedGoogle Scholar
  5. 5.
    Alpha B, Cox L, Crowther N, Clark PMS, Hales CN (1992) Sensitive amplified immunoenzymometric assays (IEMA) for human insulin and intact proinsulin. Eur J Clin Chem Clin Biochem 30: 27–32PubMedGoogle Scholar
  6. 6.
    Barker DJP, Godfrey KM, Osmond C, Bull A (1992) The relation of fetal length, ponderal index and head circumference to blood pressure and the risk of hypertension in adult life. Paediatr Perinat Epidemiol 6: 34–44Google Scholar
  7. 7.
    Robinson S, Walton RJ, Clark PM, Barker DJP, Hales CN, Osmond C (1992) The relation of fetal growth to plasma glucose in young men. Diabetologia 35: 444–446PubMedGoogle Scholar
  8. 8.
    Robinson SM, Wheeler T, Hayes MC, Barker DJP, Osmond C (1991) Fetal heart rate and intrauterine growth. Br J Obstet Gynaecol 98: 1223–1227PubMedGoogle Scholar
  9. 9.
    Beischer MA, Sivasamboo R, Vohra S, Silpisorn Rosal S, Reid S (1970) Placental hypertrophy in severe pregnancy anaemia. J Obstet Gynaecol (Br Commw) 77: 398–409Google Scholar
  10. 10.
    Godfrey KM, Redman CWG, Barker DJP, Osmond C (1991) The effect of maternal anaemia and iron deficiency on the ratio of fetal weight to placental weight. Br J Obstet Gynaecol 98: 886–891PubMedGoogle Scholar
  11. 11.
    Farchney GJ, White GA (1987) Effects of maternal nutritional status on fetal and placental growth and on fetal urea synthesis. Austr J Biol Sci 40: 365–377Google Scholar
  12. 12.
    McCrabb GJ, Egan AR, Hosking BJ (1991) Maternal undernutrition during mid-pregnancy in sheep. Placental size and its relationship to calcium transfer during late pregnancy. Br J Nutr 65: 157–168PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • K. Phipps
    • 1
  • D. J. P. Barker
    • 1
  • C. N. Hales
    • 2
  • C. H. D. Fall
    • 1
  • C. Osmond
    • 1
  • P. M. S. Clark
    • 2
  1. 1.Medical Research Council Environmental Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
  2. 2.Department of Clinical BiochemistryUniversity of Cambridge Addenbrooke's HospitalCambridgeUK

Personalised recommendations