title: Birth weight and risk of type 2 diabetes in the black women's health study: does adult BMI play a mediating role?
abstract: OBJECTIVE
  To assess the association of birth weight with incident type 2 diabetes, and the possible mediating influence of obesity, in a large cohort of U.S. black women.
  
  
  METHODS
  The Black Women's Health Study is an ongoing prospective study. We used Cox proportional hazards models to estimate incidence rate ratios (IRRs) and 95% CI for categories of birth weight (very low birth weight [<1,500 g], low birth weight [1,500-2,499 g], and high birth weight [≥4,000 g]) in reference to normal birth weight (2,500-3,999 g). Models were adjusted for age, questionnaire cycle, family history of diabetes, caloric intake, preterm birth, physical activity, years of education, and neighborhood socioeconomic status with and without inclusion of terms for adult BMI.
  
  
  RESULTS
  We followed 21,624 women over 16 years of follow-up. There were 2,388 cases of incident diabetes. Women with very low birth weight had a 40% higher risk of disease (IRR 1.40 [95% CI 1.08-1.82]) than women with normal birth weight; women with low birth weight had a 13% higher risk (IRR 1.13 [95% CI 1.02-1.25]). Adjustment for BMI did not appreciably change the estimates.
  
  
  CONCLUSIONS
  Very low birth weight and low birth weight appear to be associated with increased risk of type 2 diabetes in African American women, and the association does not seem to be mediated through BMI. The prevalence of low birth weight is especially high in African American populations, and this may explain in part the higher occurrence of type 2 diabetes.
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA eruiznar@bu.edu.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Ruiz-Narváez
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Hanna
authors.initials: H
authors.lastname: Gerlovin
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Wise
authors.affiliation: Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA.
authors.forename: Varsha G
authors.initials: VG
authors.lastname: Vimalananda
authors.affiliation: Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA.
authors.forename: James L
authors.initials: JL
authors.lastname: Rosenzweig
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001724:Birth Weight; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States; D016387:Women's Health; D055815:Young Adult