Perinatal origins of adult disease
Low birth weight has been associated not only with CHD but also with insulin resistance, and type 2 diabetes mellitus. Studies in both children and adults of various races have shown a consistent association between impaired fetal growth and measures of insulin resistance1-3, an association that has been attributed to a programmed response to intrauterine malnutrition4, 5. It was noted that lower birth weight and higher body mass index in childhood are associated with impaired glucose tolerance in these children. In a study of 407 men born in Hertfordshire, U.K. between 1920 and 1930 and 266 men and women born in Preston, U.K. between 1935 and 1943 whose weights at birth and at 1 year of age had been recorded, it was noted that the prevalence of syndrome X (characterised by type 2 diabetes mellitus, hypertension, and hypelipidemia) fell progressively in both men and women, from those who had the lowest to those who had the highest birth weights6. It was reported that of 64-year-old men whose birth weights were 2.95 kg (6.5 pounds) or less, 22% had syndrome X. This risk of developing syndrome X was almost 10 times greater than that of men whose birth weights were more than 4.31 kg (9.5 pounds). This correlation between low birth weight and Syndrome X was found to be independent of duration of gestation and other factors such as cigarette smoking, social class and alcohol consumption. These low birth weight people with Syndrome X also had small head circumference and low ponderal index at birth, and low weight and below-average dental eruption at 1 year of age. Based on these observations, it was concluded that type 2 diabetes mellitus and hypertension have a common origin in the form of sub-optimal development in utero.
KeywordsInsulin Resistance Birth Weight High Carbohydrate Diet Small Head Circumference Maternal Protein Restriction
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