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Trajectories of body mass index amongst children who develop type 2 diabetes as adults
Author(s) -
Eriksson J. G.,
Kajantie E.,
Lampl M.,
Osmond C.
Publication year - 2015
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12354
Subject(s) - medicine , body mass index , type 2 diabetes , odds ratio , confidence interval , pediatrics , birth weight , obesity , cohort study , diabetes mellitus , childhood obesity , cohort , demography , overweight , endocrinology , pregnancy , sociology , biology , genetics
Objective Type 2 diabetes (T2D) is a heterogeneous disorder. The aim of this study was to examine the trajectories of childhood growth associated with T2D. Design and subjects A total of 13 345 individuals born in Helsinki, Finland between 1934 and 1944 were included in the study. The participants' growth had been recorded in detail during childhood, and 11.7% ( n = 1558) had been diagnosed with T2D. We divided the cohort around the median body mass index ( BMI ) at 11 years. Body composition and glucose tolerance were assessed in a clinical subsample ( n = 2003) in adulthood. Results Two pathways of growth were associated with T2D. Both began with low weight and BMI at birth. In one, persistent low BMI through infancy was followed by a rapid increase in BMI in childhood. Amongst individuals with a BMI at 11 years above the median value, the odds ratio for T2D associated with a one z ‐score increase in BMI between 2 and 11 years was 1.31 (95% confidence interval 1.21–1.42, P < 0.001). In the other pathway, low BMI at birth, accompanied by short length at birth, was followed by low BMI in childhood. Most women who developed diabetes followed this trajectory; they developed T2D at a lower BMI and lower fat percentage than women with a BMI above the median at 11 years of age. Conclusions Two pathways of early growth trigger T2D. Low fat deposition leading to thinness at birth and during infancy results in fat acquisition during childhood. Reduced linear growth leading to short length at birth is associated with lower body fat percentage in adulthood but increased risk of developing diabetes.