Hansen Aleksander L, Lee Christina Ji-Young, Björgvinsdóttir Aldis H, Ahluwalia Tarunveer S, Brøns Charlotte, Torp-Pedersen Christian, Vaag Allan
Clinical research, Steno Diabetes Center Copenhagen, Herlev, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus, Denmark.
J Dev Orig Health Dis. 2025 Feb 27;16:e12. doi: 10.1017/S2040174425000066.
Low birthweight is a risk factor for type 2 diabetes. We hypothesised that differential associations between birthweight and clinical characteristics in persons with and without type 2 diabetes may provide novel insights into the role of birthweight in type 2 diabetes and its progression. We analysed UK Biobank data from 9,442 persons with and 254,446 without type 2 diabetes. Associations between birthweight, clinical traits, and genetic predisposition were assessed using adjusted linear and logistic regression, comparing the lowest and highest 25% of birthweight to the middle 50%. Each kg increase in birthweight was associated with higher BMI, waist, and hip circumference, with stronger effects in persons with versus without type 2 diabetes (BMI: 0.74 [0.58, 0.90] vs. 0.21 [0.18, 0.24] kg/m; waist: 2.15 [1.78, 2.52] vs. 1.04 [0.98, 1.09] cm; hip: 1.65 [1.33, 1.97] vs. 1.04 [1.04, 1.09] cm). Family history of diabetes was associated with higher birthweight regardless of diabetes status, albeit with a twofold higher effect estimate in type 2 diabetes. Low birthweight was further associated with prior myocardial infarction regardless of type 2 diabetes status (OR 1.33 [95% CI 1.11, 1.60] for type 2 diabetes; 1.23 [95% CI 1.13, 1.33] without), and hypertension (OR 1.25 [1.23, 1.28] and stroke 1.24 [1.14, 1.34]) only among persons without type 2 diabetes. Differential associations between birthweight and cardiometabolic traits in persons with and without type 2 diabetes illuminate potential causal inferences reflecting the roles of pre- and postnatal environmental versus genetic aetiologies and disease mechanisms.
低出生体重是2型糖尿病的一个风险因素。我们假设，出生体重与2型糖尿病患者和非2型糖尿病患者临床特征之间的差异关联，可能会为出生体重在2型糖尿病及其进展中的作用提供新的见解。我们分析了英国生物银行中9442名2型糖尿病患者和254446名非2型糖尿病患者的数据。使用校正后的线性和逻辑回归评估出生体重、临床特征和遗传易感性之间的关联，将出生体重最低和最高的25%与中间的50%进行比较。出生体重每增加1千克，与更高的体重指数、腰围和臀围相关，在2型糖尿病患者中的影响比非2型糖尿病患者更强（体重指数：0.74[0.58，0.90]对0.21[0.18，0.24]kg/m；腰围：2.15[1.78，2.52]对1.04[0.98，1.09]cm；臀围：1.65[1.33，1.97]对1.04[1.04，1.09]cm）。无论糖尿病状态如何，糖尿病家族史都与较高的出生体重相关，尽管在2型糖尿病中的效应估计值高出两倍。无论2型糖尿病状态如何，低出生体重都与既往心肌梗死进一步相关（2型糖尿病患者的比值比为1.33[95%可信区间1.11，1.60]；非2型糖尿病患者为1.23[95%可信区间1.13，1.33]），并且仅在非2型糖尿病患者中与高血压（比值比1.25[1.23，1.28]）和中风（1.24[1.14，1.34]）相关。2型糖尿病患者和非2型糖尿病患者出生体重与心脏代谢特征之间的差异关联，揭示了反映产前和产后环境与遗传病因及疾病机制作用的潜在因果推断。
