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From “Thrifty Genotype” to “Hefty Fetal Phenotype”: The Relationship Between High Birthweight and Diabetes in Saskatchewan Registered Indians

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Abstract

Background: Intrauterine factors have been implicated in the pathogenesis of Type 2 diabetes mellitus (T2DM).

Methods: In a 1:1 matched pairs case-control study, high and low birthweight (HBW, LBW) rates in Saskatchewan Registered Indian (RI) diabetic cases were compared with corresponding rates in RI without diabetes, and non-RI people with and without diabetes.

Results: Birthweights were available for 73% of the 1,366 cases and 3 × 1,366 controls. A greater proportion of RI diabetics were born with HBW (>4000 grams) compared to RI non-diabetics (16.2% vs 10.7%; p<0.01). There was a significant association between HBW (but not LBW [<2500 grams]) and diabetes for RI people (OR 1.63 [95% CI 1.20, 2.24]), which was stronger for RI females and strengthened progressively from mid to late 20th century.

Interpretation: Certain causes of HBW may predispose to subsequent development of T2DM in Canadian Aboriginal people (“hefty fetal phenotype” [“hefty fetal type”] hypothesis). Programs that optimize healthy pregnancies could reduce T2DM incidence in future generations.

Résumé

Contexte: Des facteurs intra-utérins ont été associés à la pathogénie du diabète sucré de type II (DST2).

Méthode: Dans une étude cas-témoin en paires appariées (1:1), nous avons comparé les taux d’insuffisance de poids à la naissance élevés et faibles (IPNÉ, IPNF) dans les cas de diabète chez les Indiens inscrits (Ii) de la Saskatchewan aux taux correspondants chez les Ii non diabétiques et chez les personnes non diabétiques n’étant pas des Ii.

Résultats: Nous avons obtenu le poids à la naissance de 73 % des 1 366 cas et de 3 × 1 366 témoins. La proportion d’Ii diabétiques nés avec une IPNÉ (>4 000 g) était supérieure à celle des Ii non diabétiques (16,2 % c. 10,7 %; p<0,01). L’association entre l’IPNÉ (mais non l’IPNF [<2 500 g]) et le diabète était significative chez les Ii (RC 1,63 [95 % IC 1,20, 2,24]) et plus prononcée chez les femmes; la tendance s’est renforcée progressivement entre le milieu et la fin du 20e siècle.

Interprétation: Certaines causes d’IPNÉ prédisposent peut-être au développement ultérieur du DST2 chez les Autochtones canadiens (hypothèse du «(phéno)type fœtal prononcé»). Les programmes d’optimisation de la santé durant la grossesse pourraient réduire l’incidence de DST2 pour les générations futures.

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Authors and Affiliations

  1. Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada

    Roland F. Dyck MD, FRCPC & Helena Klomp RN, MSc

  2. Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada

    Roland F. Dyck MD, FRCPC & Leonard Tan BS, MB, PhD

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  1. Roland F. Dyck MD, FRCPC
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  2. Helena Klomp RN, MSc
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  3. Leonard Tan BS, MB, PhD
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Correspondence to Roland F. Dyck MD, FRCPC.

Additional information

This research was supported by a grant from the Health Services Utilization and Research Commission (HSURC) of Saskatchewan.

This study is based in part on data provided by the Saskatchewan Department of Health. The interpretations and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Department of Health.

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Dyck, R.F., Klomp, H. & Tan, L. From “Thrifty Genotype” to “Hefty Fetal Phenotype”: The Relationship Between High Birthweight and Diabetes in Saskatchewan Registered Indians. Can J Public Health 92, 340–344 (2001). https://doi.org/10.1007/BF03404975

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