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Effects of birth size, post-natal growth and current size on insulin resistance in 9-year-old children: a prospective cohort study

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Abstract

The influence of pre-natal conditions on later type 2 diabetes risk factors such as insulin resistance (IR) may be mediated by post-natal growth trajectory. We aimed to investigate the association of body size at birth and 9 years with IR at 9 years. Using data from a prospective Australian cohort study, we examined the influence of body size from birth to 9 years [z-score for weight or body mass index (BMI)] on IR at 9 years (estimated by homeostasis model assessment). At age 9 years, 151 children provided a fasting blood sample. z-BMI at age 9 was positively associated with IR. Birth z-BMI was inversely associated with IR only after adjustment for z-BMI at age 9 years. This may be interpreted as an effect of accelerated growth between birth and 9 years on IR. There was a statistically significant interaction between birth and 9-year z-BMI. Results from regression models including z-BMI at all available time points (birth, 6 and 12 months, and 2, 3.5 and 9 years) indicate a possible inverse association between body size at 3.5 years and HOMA-IR at 9 years. Results were similar when the analyses were repeated with z-weight substituted for z-BMI. These results add to the body of evidence concerning the importance of growth in early life for later IR, and highlight a possible interaction between pre- and post-natal growth. The potential influence of growth at around 3.5 years for HOMA-IR at 9 years warrants further investigation.

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Abbreviations

BMI:

Body mass index

HOMA-IR:

Homeostasis model assessment of insulin resistance

IR:

Insulin resistance

z-BMI:

Standard deviation score for body mass index

z-Weight:

Standard deviation score for weight

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Acknowledgments

We are grateful to the women and children who have participated in the Generation 1 study and also to other family members who have supported the study. We thank Prof. Jeffrey Robinson (of the Discipline of Obstetrics & Gynaecology, The University of Adelaide) for his role in cohort establishment. We also thank Kendall Smith for study co-ordination, Suzanne Edwards for statistical analysis (both of the Discipline of Public Health, The University of Adelaide) and Dr Miles DeBlasio (of the Discipline of Obstetrics & Gynaecology, The University of Adelaide) for analyses of blood samples and the staff members involved in interviews, data base construction and data entry.

Funding

This study was supported by grants from the Faculty of Health Sciences at the University of Adelaide, the Dairy Research and Development Corporation, the Channel 7 Children’s Research Foundation, the Australian Research Council (Future Fellowship FT100101018 to MD) and the Australian National Health and Medical Research Council (Grants 465455, 465437, Career Development Award in Population Health 349548 to MD and Australian Based Public Health Training Fellowship 627033 to LG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflict of interest

The authors declare no conflicts of interest and no financial relationships with the grant funding agencies that sponsored the research.

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Authors and Affiliations

  1. Discipline of Obstetrics & Gynaecology, School of Paediatrics & Reproductive Health, The University of Adelaide, Mail Drop 327, Adelaide, SA, 5005, Australia

    Melissa J. Whitrow, Michael J. Davies, Julie A. Owens & Oana Maftei

  2. Discipline of Public Health, School of Population Health, The University of Adelaide, Adelaide, SA, Australia

    Melissa J. Whitrow, Lynne C. Giles, Oana Maftei & Vivienne M. Moore

  3. Research Centre for the Early Origins of Health and Disease, Robinson Institute, The University of Adelaide, Adelaide, SA, Australia

    Melissa J. Whitrow, Michael J. Davies, Lynne C. Giles, Julie A. Owens & Vivienne M. Moore

  4. Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

    Bianca L. De Stavola

Authors
  1. Melissa J. Whitrow
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  2. Michael J. Davies
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  3. Lynne C. Giles
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  4. Bianca L. De Stavola
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  5. Julie A. Owens
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  7. Vivienne M. Moore
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Correspondence to Melissa J. Whitrow.

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Whitrow, M.J., Davies, M.J., Giles, L.C. et al. Effects of birth size, post-natal growth and current size on insulin resistance in 9-year-old children: a prospective cohort study. Eur J Pediatr 172, 1207–1214 (2013). https://doi.org/10.1007/s00431-013-2017-4

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  • DOI: https://doi.org/10.1007/s00431-013-2017-4

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