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      Birth Weight and Risk of Type 2 Diabetes Mellitus, Cardiovascular Disease, and Hypertension in Adults: A Meta‐Analysis of 7 646 267 Participants From 135 Studies


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          Low birth weight has been associated with increased risk of type 2 diabetes mellitus, cardiovascular disease, and hypertension, but the risk at high birth weight levels remains uncertain. This systematic review and meta‐analysis aimed to clarify the shape of associations between birth weight and aforementioned diseases in adults and assessed sex‐specific risks.

          Methods and Results

          We systematically searched PubMed, EMBASE, and Web of Science for studies published between 1980 and October 2016. Studies of birth weight and type 2 diabetes mellitus (T2 DM), cardiovascular disease ( CVD), and hypertension were included. Random‐effects models were used to derive the summary relative risks and corresponding 95% confidence intervals.We identified 49 studies with 4 053 367 participants assessing the association between birth weight and T2 DM, 33 studies with 5 949 477 participants for CVD, and 53 studies with 4 335 149 participants for hypertension and high blood pressure. Sex‐specific binary analyses showed that only females had an increased risk of T2 DM and CVD at the upper tail of the birth weight distribution. While categorical analyses of 6 birth weight groups and dose‐response analyses showed J‐shaped associations of birth weight with T2 DM and CVD, the association was inverse with hypertension. The lowest risks for T2 DM, CVD, and hypertension were observed at 3.5 to 4.0, 4.0 to 4.5, and 4.0 to 4.5 kg, respectively.


          These findings indicate that birth weight is associated with risk of T2 DM and CVD in a J‐shaped manner and that this is more pronounced among females.

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          Most cited references 77

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          Fetal and infant growth and impaired glucose tolerance at age 64.

          To discover whether reduced fetal and infant growth is associated with non-insulin dependent diabetes and impaired glucose tolerance in adult life. Follow up study of men born during 1920-30 whose birth weights and weights at 1 year were known. Hertfordshire, England. 468 men born in east Hertfordshire and still living there. Fasting plasma glucose, insulin, proinsulin, and 32-33 split pro-insulin concentrations and plasma glucose and insulin concentrations 30 and 120 minutes after a 75 g glucose drink. 93 men had impaired glucose tolerance or hitherto undiagnosed diabetes. They had had a lower mean birth weight and a lower weight at 1 year. The proportion of men with impaired glucose tolerance fell progressively from 26% (6/23) among those who had weighted 18 lb (8.16 kg) or less at 1 year to 13% (3/24) among those who had weighed 27 lb (12.25 kg) or more. Corresponding figures for diabetes were 17% (4/23) and nil (0/24). Plasma glucose concentrations at 30 and 120 minutes fell with increasing birth weight and weight at 1 year. Plasma 32-33 split proinsulin concentration fell with increasing weight at 1 year. All these trends were significant and independent of current body mass. Blood pressure was inversely related to birth weight and strongly related to plasma glucose and 32-33 split proinsulin concentrations. Reduced growth in early life is strongly linked with impaired glucose tolerance and non-insulin dependent diabetes. Reduced early growth is also related to a raised plasma concentration of 32-33 split proinsulin, which is interpreted as a sign of beta cell dysfunction. Reduced intrauterine growth is linked with high blood pressure, which may explain the association between hypertension and impaired glucose tolerance.
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            Birth weight and subsequent risk of type 2 diabetes: a meta-analysis.

            The "small baby syndrome hypothesis" suggests that an inverse linear relation exists between birth weight and risk of type 2 diabetes. The authors conducted a meta-analysis to examine this association. They included studies that reported odds ratios and 95% confidence intervals (or data with which to calculate them) for the association of type 2 diabetes with birth weight. Fourteen studies involving a total of 132,180 persons were identified. Low birth weight ( /=2,500 g, was associated with increased risk of type 2 diabetes (odds ratio (OR) = 1.32, 95% confidence interval (CI): 1.06, 1.64). High birth weight (>4,000 g), as compared with a birth weight of
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              Birth weight and adult hypertension, diabetes mellitus, and obesity in US men.

              Low birth weight has been associated with several chronic diseases in adults, including hypertension, diabetes mellitus, and obesity. Further study of these diseases in a large cohort with information on a wide variety of risk factors is essential to determine more precisely the risks associated with birth weight. We examined the relation between birth weight and cumulative incidence of adult hypertension, incidence of non-insulin-dependent diabetes mellitus, and prevalence of obesity in a cohort of 22,846 US men (Health Professionals Follow-up Study). Birth weights, medical histories, family histories, and other factors were collected by biennial mailed questionnaires. Logistic regression was used to examine the association between birth weight and these chronic adult diseases. Low birth weight was associated with an increased risk of hypertension and diabetes; high birth weight was associated with an increased risk of obesity. Compared with men in the referent birth weight category (7.0 to 8.4 lb), men who weighed or = 10.0 lb was 2.08 (95% CI, 1.73 to 2.50). These findings support the hypothesis that early life exposures, for which birth weight is a marker, are associated with several chronic diseases in adulthood.

                Author and article information

                J Am Heart Assoc
                J Am Heart Assoc
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                29 November 2018
                04 December 2018
                : 7
                : 23 ( doiID: 10.1002/jah3.2018.7.issue-23 )
                [ 1 ] Epidemiology Domain Saw Swee Hock School of Public Health National University of Singapore
                [ 2 ] Department of Otolaryngology The First Hospital of China Medical University Shenyang China
                [ 3 ] Department of Epidemiology & Biostatistics College of Public Health University of Georgia Athens GA
                [ 4 ] Department of Nutrition Harvard School of Public Health Boston MA
                [ 5 ] Department of Epidemiology and Biostatistics School of Public Health Peking University Beijing China
                Author notes
                [* ] Correspondence to: Tao Huang, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China. E‐mail: huangtao@ 123456bjmu.edu.cn

                Dr Knop and Dr Geng contributed equally to this work.

                © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                Page count
                Figures: 4, Tables: 1, Pages: 13, Words: 10773
                Funded by: National University of Singapore
                Award ID: R‐608‐000‐139‐133
                Funded by: Singapore Ministry of Education
                Award ID: R‐608‐000‐161‐114
                Systematic Review and Meta‐analysis
                Systematic Review and Meta‐analysis
                Custom metadata
                04 December 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.3 mode:remove_FC converted:04.12.2018


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