Weight and length at birth and their relationship to diabetes incidence and all-cause mortality—A 32-year follow-up of the population study of women in Gothenburg, Sweden

Lapidus, Leif; Andersson, Susan W.; Bengtsson, Calle; Björkelund, Cecilia; Rossander-Hulthén, Lena; Lissner, Lauren

doi:10.1016/j.pcd.2008.05.002

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Volume 2, Issue 3 , Pages 127-133, September 2008

Weight and length at birth and their relationship to diabetes incidence and all-cause mortality—A 32-year follow-up of the population study of women in Gothenburg, Sweden

Leif Lapidus
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden
- Department of Medicine, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden
- Corresponding author at: Department of Primary Health Care, Sahlgrenska Academy, Göteborg University, Box 454, S-405 30 Göteborg, Sweden. Tel.: +46 313421000; fax: +46 31822152.
Susan W. Andersson
- Department of Clinical Nutrition, Göteborg University, Göteborg, Sweden
- AstraZeneca R&D, Mölndal, Sweden
Calle Bengtsson
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden
Cecilia Björkelund
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden
Lena Rossander-Hulthén
- Department of Clinical Nutrition, Göteborg University, Göteborg, Sweden
Lauren Lissner
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden

Received 29 January 2008; received in revised form 28 April 2008; accepted 1 May 2008. published online 01 July 2008.

Abstract

Objective

The purpose of the study was to explore the relationship of weight and length at birth to diabetes in adult life and to all-cause mortality. Special attention was taken to potential confounding factors as age, family history, education, socio-economic group, physical inactivity, smoking, blood pressure, serum lipids and obesity.

Research design and methods

A longitudinal population study consisting of a representative sample of 1381 women aged 38–54 started in Gothenburg, Sweden, in 1968–1969 monitoring for diabetes mellitus and overall mortality over 32 years. Original delivery records were retrieved for 61.2% of the women. Death certificates were obtained for 99.3% the women who died during the 32-year follow-up period.

Results

We observed an inverse statistically significant relationship between birth weight and 32-year diabetes incidence independent of age, the highest incidence 16.3% in the lowest quartile of birth weight compared to 9.2% in the highest quartile. The relationship remained when controlling for the following covariates: education, socio-economic group, physical activity, smoking, systolic blood pressure, adult body mass index (BMI), waist–hip ratio, serum triglycerides and cholesterol. When overweight women (BMI≥25) were excluded from the statistical analyses birth weight was even stronger related to the incidence of diabetes, 12.8% in lowest quartile and 5.7% in the highest quartile of birth weight independent of birth length, education, socio-economic group, physical activity, smoking, systolic blood pressure, body mass index, waist–hip ratio, blood glucose, serum triglycerides and cholesterol.

Length at birth was a predictor for diabetes independent of age plus adult body mass index (BMI) and smoking but not independent of age only.

No significant associations were observed between birth factors as birth weight and birth length and overall mortality during the 32-year of follow-up.