Abstract
Based on the fetal origins of diseases hypothesis, adverse intrauterine environment - reflected by low birth weight (LBW) - has been linked to insulin resistance and type 2 diabetes later in life. Whether β cell function reduction could be detected even in middle-aged adults is less investigated. We examined the association of LBW with β cell function and insulin sensitivity. This is a cross-sectional analysis of 2634 ELSA-Brasil participants aged between 34 and 59 years. Exclusion criteria were diabetes, glomerular filtration rate <60 ml/min/m2, thyroid dysfunction, liver disease, BMI <18.5 kg/m2 and macrosomia. Participants were stratified according to LBW defined as <2.5 kg and their clinical data were compared. HOMA-IR, HOMA-β, HOMA-adiponectin, TyG index and QUICKI were calculated. Associations of LBW with β cell function and insulin sensitivity indexes were tested using multiple linear regression including adjustments suggested by Directed Acyclic Graphs. The sample (47.0±6.3 years) was composed of 58% of women and 9% had LBW. Subjects with LBW had lower mean body weight at age 20 but similar current BMI than the normal weight born ones. In average, cardiometabolic risk profile as well as indexes of β cell function and insulin sensitivity were within normal ranges. Lower median HOMA-β values in the subset with LBW did not differ statistically from normal birth weight ones. In regression analysis, log-transformed HOMA-β - but not with the other indexes - was associated with LBW (p=0.016) independent of sex, skin color, prematurity and family history of diabetes. The association between HOMA-β and LBW suggests that decrease in insulin secretion may occur in healthy middle-aged adults. Our data are coherent with a relatively reduced β cell mass in low weight born subjects that could contribute to the risk of glucose metabolism disturbances. Disclosure J.I. Branda: None. B. Almeida Pititto: None. I.M. Bensenor: None. P.A. Lotufo: None. S.F.G. Vivolo: None. Funding Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES); CNPq - National Research Council
Published Version
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