Type 2 Diabetes in Childhood and Adolescence: A Global Perspective

By Martin Silink; Kaichi Kida et al. | Go to book overview

chapter 7

In-utero undernutrition and glucose homeostasis later in life

Delphine Jaquet, Claire Lévy-Marchal, and Paul Czernichow


Introduction

Evidence over the past 10 years has demonstrated a significant association between reduced fetal growth and the later development of metabolic and cardiovascular diseases.


Knowledge from epidemiological studies

The unexpected long-term deleterious effect of reduced fetal growth was initially observed by Barker and colleagues. This group first reported that a low birth weight was significantly associated with an increased risk for the later development of cardiovascular diseases or type 2 diabetes in a cohort of Caucasian males aged 64 years. 1,2 Other epidemiological studies performed in Pima Indians or in Caucasian subjects later confirmed this observation, suggesting that the association holds true whether the study populations are genetically predisposed or not to type 2 diabetes. 3,4

The independent effect of thinness at birth, assessed by the ponderal index, and the lack of association with gestational age on these complications observed in several studies support the hypothesis of deleterious effect of reduced fetal growth rather than prematurity on this associa-tion. 2,4

Numerous epidemiological studies have demonstrated that being born with a low birth weight is also associated with hypertension 1,5 or

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