Glucose tolerance at age 58 and the decline of glucose tolerance in comparison with age 50 in people prenatally exposed to the Dutch famine.
OBJECTIVE
People who were small at birth have an increased risk of type 2 diabetes in later life. People who were in utero during the Dutch famine had decreased glucose tolerance and raised insulin concentrations at age 50. We aimed to evaluate whether prenatal famine exposure leads to more rapid progression of impaired glucose/insulin homeostasis with increasing age.


METHODS
We performed an OGTT in 702 men and women at age 50 and in 699 men and women at age 58, all born as term singletons immediately before, during or after the 1944-1945 Dutch famine.


RESULTS
People who had been exposed to famine in utero had significantly higher 120-min glucose concentrations at age 58 compared with people who had not been exposed to famine (difference=0.4 mmol/l, 95% CI 0.1 to 0.7, adjusted for sex and BMI). Glucose tolerance deteriorated between the age of 50 and 58. The unadjusted 120-min glucose concentrations rose by 0.2 mmol/l (95% CI 0.0 to 0.4), while 120-min insulin concentrations had increased by 64 pmol/l (95% CI 48 to 82). There were no differences in the rates of glucose and insulin level increase between the famine-exposed group and the unexposed group (p=0.28 for the difference in increase in glucose concentrations and p=0.09 for insulin concentrations).


CONCLUSIONS
Although we confirmed that undernutrition during gestation is linked to decreased glucose tolerance, the effect does not seem to become more pronounced at age 58 as compared with age 50.
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, 1100 DD, Amsterdam, the Netherlands. s.r.derooij@amc.uva.nl
S R
SR
de Rooij
R C
RC
Painter
T J
TJ
Roseboom
D I W
DI
Phillips
C
C
Osmond
D J P
DJ
Barker
M W
MW
Tanck
R P J
RP
Michels
P M M
PM
Bossuyt
O P
OP
Bleker
D000328:Adult; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D039401:Prenatal Nutritional Physiological Phenomena / Q000502:physiology*; D013217:Starvation / Q000453:epidemiology* / Q000503:physiopathology*
D001786:Blood Glucose; D007328:Insulin