title: Critical periods and growth patterns from fetal life onwards associated with childhood insulin levels.
abstract: We aimed to identify critical periods and specific longitudinal growth patterns from fetal life onwards associated with childhood insulin and C-peptide levels.
  
  
  
  In a prospective population-based cohort study of 4328 children, we repeatedly measured (femur) length and (estimated fetal) weight from the second trimester of fetal life until 6 years of age. BMI was calculated from 6 months onwards. Insulin and C-peptide levels were measured at 6 years of age.
  
  
  
  Preterm birth and small or large size for gestational age at birth were not associated with childhood insulin levels. Conditional growth modelling showed that, independent of growth in other time intervals, weight growth in each time interval from birth onwards, length growth from 6 months onwards and BMI growth from 12 months onwards were positively associated with childhood insulin levels. The strongest associations were present for weight and BMI growth between 48 and 72 months of age. Repeated measurement analyses showed that, compared with children in the lowest quartile of childhood insulin, those in the highest quartile had a higher length from birth onwards and a higher weight and BMI from 24 months onwards. These differences increased with age. No associations were observed for fetal growth characteristics. Similar results were observed for C-peptide levels.
  
  
  
  Our results suggest that rapid length, weight and BMI growth from birth onwards, but not during fetal life, is associated with higher insulin levels in childhood.
authors.affiliation: The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Ellis
authors.initials: E
authors.lastname: Voerman
authors.affiliation: The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.affiliation: The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. r.gaillard@erasmusmc.nl.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. r.gaillard@erasmusmc.nl.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. r.gaillard@erasmusmc.nl.
authors.forename: Romy
authors.initials: R
authors.lastname: Gaillard
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005317:Fetal Growth Retardation / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000097:blood; D011446:Prospective Studies
chemical_list: D002096:C-Peptide; D007328:Insulin
keywords: Body mass index; C-peptide; Childhood; Fetal life; Growth; Insulin; Length; Prospective cohort