Fetal and infant growth and impaired glucose tolerance at age 64.

Bibliographic Data

ID23319203
AuthorsC N Hales (University of Cambridge), David J Barker (0000-0002-4609-6787, University of Cambridge), P Clark (0000-0002-6442-2064, University of Cambridge), P M Clark, Lorna Cox (University of Cambridge), L J Cox, Caroline Fall (0000-0003-4402-5552, University of Cambridge), Clive Osmond (0000-0002-9054-4655, University of Cambridge), P D Winter (0000-0001-7970-6951, University of Cambridge)
Year1991
Volume303
Issue6809
Pages1019-1022
Publication date1991-10-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ (JOURNAL)
Journal identifiersISSN: 0007-1447 • E-ISSN: 0267-0623
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmj.303.6809.1019
PMID1954451
OpenAlexW2031792984
LanguageEN
Citations received91
References cited12

OBJECTIVE: To discover whether reduced fetal and infant growth is associated with non-insulin dependent diabetes and impaired glucose tolerance in adult life. DESIGN: Follow up study of men born during 1920-30 whose birth weights and weights at 1 year were known. SETTING: Hertfordshire, England. SUBJECTS: 468 men born in east Hertfordshire and still living there. MAIN OUTCOME MEASURES: Fasting plasma glucose, insulin, proinsulin, and 32-33 split pro-insulin concentrations and plasma glucose and insulin concentrations 30 and 120 minutes after a 75 g glucose drink. RESULTS: 93 men had impaired glucose tolerance or hitherto undiagnosed diabetes. They had had a lower mean birth weight and a lower weight at 1 year. The proportion of men with impaired glucose tolerance fell progressively from 26% (6/23) among those who had weighted 18 lb (8.16 kg) or less at 1 year to 13% (3/24) among those who had weighed 27 lb (12.25 kg) or more. Corresponding figures for diabetes were 17% (4/23) and nil (0/24). Plasma glucose concentrations at 30 and 120 minutes fell with increasing birth weight and weight at 1 year. Plasma 32-33 split proinsulin concentration fell with increasing weight at 1 year. All these trends were significant and independent of current body mass. Blood pressure was inversely related to birth weight and strongly related to plasma glucose and 32-33 split proinsulin concentrations. CONCLUSIONS: Reduced growth in early life is strongly linked with impaired glucose tolerance and non-insulin dependent diabetes. Reduced early growth is also related to a raised plasma concentration of 32-33 split proinsulin, which is interpreted as a sign of beta cell dysfunction. Reduced intrauterine growth is linked with high blood pressure, which may explain the association between hypertension and impaired glucose tolerance.

Biology · Birth weight · Diabetes mellitus · Fetus · Glucose tolerance test · Impaired glucose tolerance · Insulin · Insulin resistance · Pregnancy · Proinsulin · Birth, Development, and Health · Endocrinology · Gestational Diabetes Research and Management · Internal Medicine · Medicine · Pancreatic function and diabetes

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