OBJECTIVE Recent studies have demonstrated an association between low birth weight and chronic and metabolic disorders in adulthood such as type 2 diabetes, hypertension, and dyslipidemia. These disorders tend to cluster in a condition known as the metabolic syndrome (syndrome X). Only two studies have reported an association of birth weight to the metabolic syndrome. The present study is distinguished as the only study to focus on postmenopausal women.

RESEARCH DESIGN AND METHODS Subjects were 303 community-dwelling, postmenopausal Caucasian women aged 50–84 years. Metabolic and anthropometric variables were measured at a clinic visit; birth weight was assessed by self-report on a mailed questionnaire.

RESULTS The metabolic syndrome, defined as the simultaneous presence of hypertension, dyslipidemia, and abnormal glucose tolerance, was present in 7.9% of these women. Compared with women in the highest birth weight tertile (8.1–13.0 lb, mean 9.4 lb), those in the lowest birth weight tertile (2.5–6.8 lb, mean 5.5 lb) exhibited an increased prevalence (12.0 vs. 4.3%, P < 0.05) and 2.41 times the risk (95% CI 1.06–5.51) of developing the metabolic syndrome. Women with a heavy birth weight had an increased risk of adult obesity. Nevertheless, women in the lowest birth weight tertile who became adults in the highest tertile of BMI (>25.2 kg/m²) or waist circumference (>80.7 cm) had the highest prevalence of the metabolic syndrome (∼30%).

CONCLUSIONS Low birth weight coupled with adult obesity is a strong determinant of the metabolic syndrome in postmenopausal women.