Fetal and infant growth and impaired glucose tolerance at age 64.
OBJECTIVE
To discover whether reduced fetal and infant growth is associated with non-insulin dependent diabetes and impaired glucose tolerance in adult life.


METHODS
Follow up study of men born during 1920-30 whose birth weights and weights at 1 year were known.


METHODS
Hertfordshire, England.


METHODS
468 men born in east Hertfordshire and still living there.


METHODS
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.
Hales
C N
CN
Department of Clinical Biochemistry, University of Cambridge, Addenbrooke's Hospital.
Barker
D J
DJ
Clark
P M
PM
Cox
L J
LJ
Fall
C
C
Osmond
C
C
Winter
P D
PD
D000368:Aged; D001724:Birth Weight / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011384:Proinsulin / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D011384:Proinsulin