Fetal growth and impaired glucose tolerance in men and women
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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 wordsImpaired glucose tolerance non-insulin-dependent diabetes mellitus fetal growth ponderal index at birth placental weight to birthweight ratio
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- 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.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.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
- 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
- 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
- 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