Early growth and type 2 diabetes: evidence from the 1946 British birth cohort.
OBJECTIVE
We assessed whether low birthweight or early adiposity rebound was more strongly associated with type 2 diabetes, and whether any effect of low birthweight or early adiposity rebound was explained by adult BMI, adult height, social class of subject or of his/her father, or maternal or paternal diabetes.


METHODS
Cox's proportional hazard models were used on data from the National Birth Cohort Study (the MRC National Survey of Health and Development), which was begun in 1946 and had self-reported physician-diagnosed diabetes with age at onset ranging from 31 to 53 years (n=78 cases, and n=47 cases in the multivariate analysis) as the outcome.


RESULTS
A U-shaped association between birthweight and type 2 diabetes rates was close to statistical significance (quadratic term p value=0.08). Younger age at adiposity rebound was associated with increased rates of type 2 diabetes (test for trend p=0.002), the association being robust to adjustment for each of sex, birthweight, weight at 2 years, father's social class, parental diabetes, and own social class. The effect of early adiposity rebound was very slightly reduced by adjustment for sex and adult height (p=0.003), but considerably reduced after adjustment for sex and adult BMI (test for trend p=0.1), and further reduced (p=0.4) after additional adjustment for birthweight, weight at 2 years, adult height, social class of subject and of his/her father, and parental diabetes.


CONCLUSIONS
Early adiposity rebound was associated with an increased rate of type 2 diabetes independently of birthweight, but its effect was mostly through high adult BMI. Parental diabetes and possibly low weight at 2 years were also risks.
Wadsworth
M
M
MRC National Survey of Health & Development, Department of Epidemiology & Public Health, University College London Medical School, London, UK. m.wadsworth@nshd.mrc.ac.uk
Butterworth
S
S
Marmot
M
M
Ecob
R
R
Hardy
R
R
D050154:Adiposity; D000293:Adolescent; D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006128:Growth / Q000502:physiology*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012727:Sex Characteristics; D012923:Social Class; D006113:United Kingdom / Q000453:epidemiology