Impact of birth weight on adult-onset diabetes mellitus in relation to current body mass index: The Japan Nurses' Health Study

Kota Katanoda,Mitsuhiko Noda,Kunihiko Hayashi,Jung Su Lee,Hideki Mizunuma,Atsushi Goto

doi:10.1016/j.je.2016.08.016

Kota Katanoda, Mitsuhiko Noda + Show 4 more

Open Access

https://doi.org/10.1016/j.je.2016.08.016

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Abstract

BackgroundAlthough birth weight is considered as a fetal determinant of the development of adult-onset diabetes mellitus (DM), its public health importance relative to adult body mass index (BMI) remains unclear. We aimed to examine the association between adult-onset DM and birth weight in relation to adult BMI.MethodsWe conducted a self-administered questionnaire as a baseline survey of the Japanese Nurses' Health Study cohort between 2001 and 2007. Exclusion criteria were applied to the volunteer sample of 49,927 female nurses (age <30 years or unknown, current pregnancy, development of DM before the age of 30 years, unknown core variables), and data from 26,949 female nurses aged 30 years or older were used. The association between history of DM diagnosis and birth weight was analyzed using logistic regression.ResultsA linear inverse association was observed between birth weight and DM, after adjustment for age, BMI, and parental history of DM. The odds ratio for developing DM per 100 g increase in birth weight was 0.93 (95% confidence interval [CI], 0.90–0.96). The association was unchanged when birth weight was converted to percentile for gestational age. In the BMI-stratified analysis, the odds ratio for DM in the <2500 g birth weight group reached 4.75 (95% CI, 1.22–18.44, compared to the reference 3000–3499 g group) among women with normal low BMI (18.5–20.9).ConclusionsBirth weight and its percentile for gestational age were associated with adult-onset DM. Attention should be paid to the risk of DM among women born with low weight, even when their current BMI is normal.

Highlights

Adult-onset diabetes mellitus (DM) is a major global medical burden
Important questions have not been addressed, such as whether we should be cautious about developing DM even when current body mass index (BMI) is normal, and how DM risk changes according to the combination of birth weight and current BMI levels.[5]
There was a U-shaped association between current BMI and birth weight, and the 2500e2999 g birth weight group had the lowest current BMI

Summary

Introduction

Adult-onset diabetes mellitus (DM) is a major global medical burden. Globally, an estimated 1.3 million deaths were attributed to DM in 2010, twice as many as in 1990.1 There have been systematic reviews of the association between birth weight and adult-onset DM,[2,3] one of which reported that the risk of DM decreased by 30% for every 1 kg increase in birth weight.[3]. The association between birth weight and adult-onset DM is biologically explained as an adaptation to intrauterine undernutrition.[4] If this hypothesis is true, the effect of being small for gestational age will be more important. Birth weight is considered as a fetal determinant of the development of adultonset diabetes mellitus (DM), its public health importance relative to adult body mass index (BMI) remains unclear. In the BMI-stratified analysis, the odds ratio for DM in the

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