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Relation of Serial Changes in Childhood Body-Mass Index to Impaired Glucose Tolerance in Young Adulthood
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BACKGROUND: The risk of type 2 diabetes mellitus is increased in people who have low birth weights and who subsequently become obese as adults. Whether their obesity originates in childhood and, if so, at what age are unknown. Understanding the origin of obesity may be especially important in developing countries, where type 2 diabetes is rapidly increasing yet public health messages still focus on reducing childhood "undernutrition." METHODS: We evaluated glucose tolerance and plasma insulin concentrations in 1492 men and women 26 to 32 years of age who had been measured at birth and at intervals of three to six months throughout infancy, childhood, and adolescence in a prospective, population-based study. RESULTS: The prevalence of impaired glucose tolerance was 10.8 percent, and that of diabetes was 4.4 percent. Subjects with impaired glucose tolerance or diabetes typically had a low body-mass index up to the age of two years, followed by an early adiposity rebound (the age after infancy when body mass starts to rise) and an accelerated increase in body-mass index until adulthood. However, despite an increase in body-mass index between the ages of 2 and 12 years, none of these subjects were obese at the age of 12 years. The odds ratio for disease associated with an increase in the body-mass index of 1 SD from 2 to 12 years of age was 1.36 (95 percent confidence interval, 1.18 to 1.57; P<0.001). CONCLUSIONS: There is an association between thinness in infancy and the presence of impaired glucose tolerance or diabetes in young adulthood. Crossing into higher categories of body-mass index after the age of two years is also associated with these disorders.
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“Genetic and phenotypic differences due to foetal and childhood nutrition and growth also influence worldwide variations, especially when accompanied with rapid weight gain—for example the high diabetes prevalence in south Asia.56,57”
From Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants (2024) · cites this paper as [57]
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Metadata
- Authors
- Bhargava, S. K., Sachdev, H. S., Fall, C. H. D., Osmond, C., Lakshmy, R., Barker, D. J. P., Biswas, S. K. D., Ramji, S., Prabhakaran, D., & Reddy, K. S.
- Affiliations
- Sunder Lal Jain Hospital (IN)
- Maulana Azad Medical College (IN)
- Southampton General Hospital (GB)
- Indian Council of Medical Research (IN)
- All India Institute of Medical Sciences (IN)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-02-26
- Volume
- 350
- Issue
- 9
- Pages
- 865-875
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3408694
- OpenAlex
- W1974959407
- Cited by
- 1,037
- References
- 18
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 24 · 2023: 26 · 2022: 28 · 2021: 45 · 2020: 29 · 2019: 37 · 2018: 38 · 2017: 31 · 2016: 44 · 2015: 41 · 2014: 58 · 2013: 57 · 2012: 68
- FWCI
- 65.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- British Heart Foundation (PG/05/046/18730)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- childhood body mass index, impaired glucose tolerance, type 2 diabetes, low birth weight, adiposity rebound, childhood obesity, plasma insulin, young adults, developmental origins of health and disease
- MeSH terms
- Adult, Birth Weight, Child, Child, Preschool, Diabetes Mellitus, Type 2, Female, Growth, Humans, India, Infant, Newborn, Insulin, Male, Obesity, Thinness, Cohort Studies, Body Mass Index, Prevalence, Odds Ratio, Glucose Intolerance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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