Association between birth weight and diabetes: Role of body mass index and lifestyle in later life

J Diabetes. 2020 Jan;12(1):10-20. doi: 10.1111/1753-0407.12960. Epub 2019 Jul 9.

Abstract

Background: This study investigated the association between birth weight and diabetes in a Chinese population, and the effects of body mass index (BMI) and lifestyle factors in later life on this association.

Methods: Data from 49 118 participants aged ≥40 years with recalled birth weight from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, a nationwide population-based cohort, were used. Diabetes diagnosis was based on oral glucose tolerance tests and HbA1c measurements. Logistic regression models were used to evaluate the association of birth weight and risk of diabetes in later life.

Results: Increased risk of diabetes was associated with lower or higher birth weight. Compared with individuals with a birth weight of 2500 to 3499 g, the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes for individuals with a birth weight of <2500, between 3500 and 3999, and ≥4000 g were 1.28 (1.11-1.47), 1.11 (1.04-1.19), and 1.20 (1.07-1.34), respectively. Significant associations were prominent in participants with a current BMI ≥24 kg/m2 , but not detected in those with a normal BMI (OR 1.20 [95% CI 0.96-1.49], 1.11 [95% CI 0.98-1.25], and 1.10 [95% CI 0.89-1.37], respectively). Moreover, there was no increased risk of diabetes in individuals with a low birth weight but with healthy dietary habits (OR 0.94; 95% CI 0.68-1.29) or ideal physical activity (OR 1.41; 95% CI 0.97-2.04).

Conclusions: A U-shaped association was observed between birth weight and the risk of diabetes. Healthy lifestyles (healthy dietary habits or ideal physical activity) may eliminate the negative effects of low birth weight in the development of diabetes, but not the effect of high birth weight.

背景: 本研究旨在调查中国中老年人群出生体重与糖尿病之间的关系, 以及成年后体重指数(body mass index, BMI)和生活方式是否会影响这种关联。 方法: 我们的研究人群来自全国性的REACTION研究, 即中国2型糖尿病患者肿瘤发生风险的流行病学研究(Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study, REACTION)。最终, 49118名40岁及以上的参与者被纳入研究, 并按回忆的出生体重分为四组:<2500 g, 2500~3499 g, 3500~3999 g, ≥4000 g。 糖尿病的诊断基于口服葡萄糖耐量试验和糖化血红蛋白测定。Logistic回归模型用于评估出生体重与成年后糖尿病风险之间的关系。 结果: 低出生体重或高出生体重都与成年后糖尿病发生有关。与出生体重2500~3499g的人相比, 出生体重<2500g、3500~3999g、≥4000g的参与者其多因素校正后的糖尿病比值比(OR)和95%置信区间(CI)分别为1.28(1.11~1.47), 1.11(1.04~1.19)和1.20(1.07~1.34)。在BMI ≥ 24 kg/m2 的参与者中, 出生体重与糖尿病的这种相关性显著, 但在BMI正常者中无显著差异(OR, 95% CI分别为:1.20, 0.96~1.49;1.11, 0.98~1.25和1.10, 0.89~1.37)。此外, 在低出生体重但饮食习惯健康或具有理想体力活动的人群中并未发现糖尿病风险显著升高(OR, 95% CI分别为:0.94, 0.68~1.29;1.41, 0.97~2.04)。 结论: 我们的研究表明, 出生体重和成年后糖尿病风险之间呈U形关联。健康的生活方式(如健康的饮食习惯或理想的体力活动)可以抵消低出生体重对糖尿病发生风险的影响, 但不能消除高出生体重的影响。.

Keywords: birth weight; body mass index; diabetes; lifestyle; 体重指数; 出生体重; 生活方式; 糖尿病.

MeSH terms

  • Aged
  • Asian Continental Ancestry Group / statistics & numerical data
  • Birth Weight*
  • Body Mass Index*
  • China / epidemiology
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / ethnology
  • Feeding Behavior*
  • Female
  • Glucose Tolerance Test
  • Glycated Hemoglobin A / analysis
  • Humans
  • Life Style*
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human