Body Size at Birth and Risk of Type 2 Diabetes in Adult Life

  • Yiqing Song
  • Lu Wang
  • Edwina Yeung
  • Cuilin Zhang


A large body of evidence supports the hypothesis that the risk of developing chronic diseases including type 2 diabetes (T2D) in adulthood is related to body size at birth. Birth weight may reflect fetal adaptation to an adverse intrauterine environment due to both genetic and environmental factors. Epidemiologic studies, primarily from prospective cohorts, have consistently shown that birth weight in the 2,500–4,000 g range is inversely associated with T2D risk in adulthood, while increased risk has been found at both extremes of low (< 2,500g) and high (> 4,000g) birth weight. The association between birth weight and risk of T2D can be modified by postnatal growth. Recent evidence appears to support that low birth weight may be related to rapid postnatal weight gain, which has been associated with increased risk for central obesity and T2D in adult life. Several mechanisms have been proposed to explain the robust association between birth weight and T2D. The “fetal origins hypothesis” remains the most popular one and has been revised based on recent evidence. This review aims to summarize both epidemiological and experimental observations relating birth weight and rapid postnatal weight gain to T2D risk in adulthood. This article will also highlight recent evidence on the mechanisms of fetal programming of diabetes due to maternal and fetal genetic factors as well as fetal epigenetic changes.


Birth Weight High Birth Weight Fetal Programming Rapid Weight Gain Adiposity Rebound 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Angiotensin-converting enzyme


Body mass index


Cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1


Cyclin-dependent kinase inhibitor 2A/2B


Confidence interval


Cardiovascular disease


Fat mass and obesity-associated gene


Glucokinase gene


Genome-wide association studies


Adult skeletal muscle gene


Human hemochromatosis gene


Hematopoietically expressed homeobox/insulin-degrading enzyme


Hypothalamic-pituitary-adrenal axis


Insulin-like growth factor


Insulin-like growth factor-I


Insulin-like growth factor type 1 receptor


Insulin gene


Intrauterine growth restriction


Juxtaposed with another zinc finger gene 1


Potassium inwardly-rectifying channel protein gene, subfamily 1, member 11


Melanocortin 4 receptor


Odds ratio


Pancreatic and duodenal homeobox 1


Peroxisome proliferator-activated receptor gamma gene


Relative risk


Small for gestational age


Transcription factor 7-like 2 gene


Type 2 diabetes mellitus


United Kingdom


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of Preventive MedicineBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Epidemiology Branch, Division of Epidemiology, Statistics, and Prevention ResearchEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthBethesdaUSA

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