From "thrifty genotype" to "hefty fetal phenotype": the relationship between high birthweight and diabetes in Saskatchewan Registered Indians.
BACKGROUND
Intrauterine factors have been implicated in the pathogenesis of Type 2 diabetes mellitus (T2DM).


METHODS
In a 1:1 matched pairs case-control study, high and low birthweight (HBW, LBW) rates in Saskatchewan Registered Indian (RI) diabetic cases were compared with corresponding rates in RI without diabetes, and non-RI people with and without diabetes.


RESULTS
Birthweights were available for 73% of the 1,366 cases and 3 x 1,366 controls. A greater proportion of RI diabetics were born with HBW (> 4000 grams) compared to RI non-diabetics (16.2% vs 10.7%; p < 0.01). There was a significant association between HBW (but not LBW [< 2500 grams]) and diabetes for RI people (OR 1.63 [95% CI 1.20, 2.24]), which was stronger for RI females and strengthened progressively from mid to late 20th century.


CONCLUSIONS
Certain causes of HBW may predispose to subsequent development of T2DM in Canadian Aboriginal people ("hefty fetal phenotype" ["hefty fetal type"] hypothesis). Programs that optimize healthy pregnancies could reduce T2DM incidence in future generations.
Dyck
R F
RF
College of Medicine, University of Saskatchewan, Saskatoon, SK. dyck@sask.usask.ca
Klomp
H
H
Tan
L
L
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D007198:Indians, North American / Q000235:genetics*; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D015999:Multivariate Analysis; D016017:Odds Ratio; D010641:Phenotype; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000208:ethnology* / Q000235:genetics*; D012042:Registries; D012525:Saskatchewan / Q000453:epidemiology; D017678:Sex Distribution