Birth weight, type 2 diabetes, and insulin resistance in Pima Indian children and young adults.
OBJECTIVE
To investigate the mechanisms underlying the association between birth weight and type 2 diabetes in a population-based study of 3,061 Pima Indians aged 5-29 years.


METHODS
Glucose and insulin concentrations were measured during a 75-g oral glucose tolerance test, and insulin resistance was estimated according to the homeostatic model (homeostasis model assessment-insulin resistance [HOMA-IR]). Relationships between birth weight, height, weight, fasting and postload concentrations of glucose and insulin, and HOMA-IR were examined with multiple regression analyses.


RESULTS
Birth weight was positively related to current weight and height (P < 0.0001, controlled for age and sex, in each age-group). The 2-h glucose concentrations showed a U-shaped relationship with birth weight in subjects > 10 years of age, and this relation was independent of current body size. In 2,272 nondiabetic subjects, after adjustment for weight and height, fasting and 2-h insulin concentrations and HOMA-IR were negatively correlated with birth weight.


CONCLUSIONS
Low-birth-weight Pimas are thinner at ages 5-29 years, yet they are more insulin resistant relative to their body size than those of normal birth weight. By contrast, those with high birth weight are more obese but less insulin resistant relative to their body size. The insulin resistance of low-birth-weight Pima Indians may explain their increased risk for type 2 diabetes.
Dabelea
D
D
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona 85014, USA.
Pettitt
D J
DJ
Hanson
R L
RL
Imperatore
G
G
Bennett
P H
PH
Knowler
W C
WC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001130:Arizona / Q000453:epidemiology; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007198:Indians, North American; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D011237:Predictive Value of Tests; D012737:Sex Factors
D001786:Blood Glucose; D007328:Insulin