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Published online December 10, 2007
Diabetes Care 31:483-487, 2008
DOI: 10.2337/dc07-1130
© 2008 by the American Diabetes Association
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Epidemiology/Health Services Research
Original Research

Evidence of a Relationship Between Infant Birth Weight and Later Diabetes and Impaired Glucose Regulation in a Chinese Population

Xinhua Xiao, MD1, Zhen-Xin Zhang, MD2, Harvey Jay Cohen, MD3, Heng Wang, MD1, Wenhui Li, MD1, Tong Wang, MB1, Tao Xu, PHD4, Aimin Liu, MD5, Ming-Ying Gai, MD6, Shen Ying, MB7, Ole Schmitz, MD8 and Zeng Yi, PHD9

1 Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
2 Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
3 Center for the Study of Aging and Human Development, Department of Medicine, Duke University, Durham, North Carolina
4 Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College and Institute of Basic Medical Science, Chinese Academy of Medical Sciences, Beijing, China
5 Case Registry Office, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
6 Department of Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
7 Center of Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
8 Department of Endocrinology and Diabetes, Aarhus University Hospital, Aarhus, Denmark
9 Center for the Study of Aging and Human Development, Department of Medicine, Duke University, Durham, North Carolina, and China Center for Economic Research of Peking University, Beijing, China

Address correspondence and reprint requests to Dr. Zhen-Xin Zhang, Department of Neurology and Clinical Epidemiology Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Wangfujing, Beijing 100730, China. E-mail: wuzhangzhenxin{at}medmail.com.cn

OBJECTIVE—The aim of this study was to determine the influence of birth weight, a marker of fetal growth, on the development of later impaired glucose metabolism throughout the life span of people living in China.

RESEARCH DESIGN AND METHODS—We recorded detailed anthropometric data including height, weight, and health status and measured blood glucose levels and insulin concentrations after fasting and at 120 min of a standard oral glucose tolerance test from 2,019 eligible subjects born between 1921 and 1954 to investigate the risk of developing type 2 diabetes and impaired glucose regulation (IGR).

RESULTS—The diabetes and IGR groups were characterized by significantly lower birth weight (P < 0.001), smaller head circumference (P < 0.001), smaller ponderal index (P = 0.007), and shorter length (P = 0.004) compared with those in the normal glucose tolerance group. Using multiple logistic regression analysis, we observed that birth weight remained significantly associated with diabetes and IGR after adjustments for possible confounding variables at birth and in adult life such as sex, age, central obesity, smoking status, alcohol consumption, dyslipidemia, family history of diabetes, and occupational status (P = 0.027). There was a significantly increased risk of getting diabetes and IGR for those with low birth weight (odds ratio 1.748 [95% CI 1.018–3.001], P = 0.043).

CONCLUSIONS—The results confirm that lower birth weight is an independent risk factor for later diabetes or IGR and show for the first time that this risk factor also applies for a Chinese population.

Abbreviations: HOMA-IR, homeostasis model assessment of insulin resistance • IGR, impaired glucose regulation • NGT, normal glucose tolerance • PUMCH, Peking Union Medical College Hospital


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