Low Birth Weight May Be
Marker of Type 2 Diabetes
NEW YORK (Reuters Health)
- Babies weighing less than 5.5 pounds (2.5 kilograms) at birth
may be more likely to develop insulin resistance, a precursor
to type 2 diabetes and heart disease, researchers report.
Their study found that insulin resistance syndrome (IRS), a condition
marked by elevated levels of insulin in the blood, low HDL (''good'')
cholesterol, obesity and elevated blood fats, was more common
among these low birth weight (LBW) babies by the time they reached
the ages of 8 to 14. The association was even stronger for black
children, according to the report in the December issue of Diabetes
The findings suggest that fetal malnutrition can lead to permanent
alterations of the beta cells, the insulin-producing cells of
the pancreas. The results also underscore the importance of proper
nutrition during pregnancy, report Dr. Chaoyang Li and colleagues
from the University of Southern California in Los Angeles.
In an interview with Reuters Health, study author Dr. Michael
J. Goran said the findings suggest another risk factor for type
``Screening for type 2 diabetes is important for children and
adolescents, especially if they are overweight, have a positive
family history of type 2 diabetes and are African American, Native
American or Hispanic,'' Goran said. ``On top of these risk factors
we can now add low birth weight, especially for African-American
It is not clear why LBW was more strongly associated with insulin
resistance among black children, but Goran suggested that an interaction
between genetic and environmental factors may be at work. Alternatively,
African Americans have been shown to have higher insulin secretion
in general, and respond to insulin resistance by secreting even
``Over-secretion may wear down the beta cells quicker,'' he said.
Researchers have long known that LBW boosts the risk of IRS,
type 2 diabetes and heart disease among adults, but the association
between birth weight and insulin resistance in children is unclear.
To investigate, Goran and colleagues measured blood fats, blood
sugar and insulin levels after an overnight fast in 139 children
at four different times.
LBW was associated with higher fasting insulin, lower HDL cholesterol
and increased abdominal fat among all children and significantly
associated with these traits among African-American children.
``The findings suggest that hyperinsulinemia, decreased beta-cell
function, (elevated blood fats) and central obesity, which are
associated with LBW, might be the first components of IRS during
childhood,'' the study authors conclude.
Although the study did not investigate how fetal malnutrition
may contribute to insulin resistance, the findings indicate that
impaired growth of the liver during pregnancy can contribute to
a lifetime of problems metabolizing fat.
Goran recommends that future studies track normal birth weight
and low birth weight children beyond puberty to determine whether
the risk of developing type 2 diabetes persists. Studies examining
the effects of weight loss and exercise on insulin sensitivity
are also needed, he said in an interview.
SOURCE: Diabetes Care 2001;24:2035-2042.
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