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Cited by 1,517Birth, Development, and HealthDiabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, Diet

Trajectories of growth among children who have coronary events as adults

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Barker, David J.P., Osmond, Clive, Forsén, Tom J., Kajantie, Eero, Eriksson, Johan G.·2005·New England Journal of Medicine
DOI 10.1056/nejmoa044160
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Abstract

BACKGROUND: Low birth weight is a risk factor for coronary heart disease. It is uncertain how postnatal growth affects disease risk. METHODS: We studied 8760 people born in Helsinki from 1934 through 1944. Childhood growth had been recorded. A total of 357 men and 87 women had been admitted to the hospital with coronary heart disease or had died from the disease. Coronary risk factors were measured in a subset of 2003 people. RESULTS: The mean body size of children who had coronary events as adults was below average at birth. At two years of age the children were thin; subsequently, their body-mass index (BMI) increased relative to that of other children and had reached average values by 11 years of age. In simultaneous regressions, the hazard ratios associated with a 1 SD increase in BMI were 0.76 (95 percent confidence interval, 0.66 to 0.87; P<0.001) at 2 years and 1.14 (95 percent confidence interval, 1.00 to 1.31; P=0.05) at 11 years among the boys. The corresponding figures for the girls were 0.62 (95 percent confidence interval, 0.46 to 0.82; P=0.001) and 1.35 (95 percent confidence interval, 1.02 to 1.78; P=0.04). Low BMI at 2 years of age and increased BMI from 2 to 11 years of age were also associated with raised fasting insulin concentrations (P<0.001 for both). CONCLUSIONS: On average, adults who had a coronary event had been small at birth and thin at two years of age and thereafter put on weight rapidly. This pattern of growth during childhood was associated with insulin resistance in later life. The risk of coronary events was more strongly related to the tempo of childhood gain in BMI than to the BMI attained at any particular age.

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  • Undernutrition and low birth weight were also associated with insulin resistance in this population later in life.

    “Undernutrition and low birth weight was also associated with insulin resistance in this population later in life [42].”

    From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [42]

    The coronary risk factors section reports that raised fasting insulin and proinsulin, measures of insulin resistance, were associated with low birth weight in later life. It discusses fetal undernutrition as a possible explanation, but does not report a measured association between undernutrition and insulin resistance in this cohort. (LLM, conf=0.87)

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  • The DOHaD theory proposed that nutrient restriction during specific periods of development influences susceptibility for cardiovascular and metabolic diseases in adulthood.

    “Thus, the DOHaD theory proposed that nutrient restriction during specific periods of development (e.g., conception, gestation and the first few years of life), when tissues and organs are particularly sensitive to environmental exposures, as a consequence influence the susceptibility for cardiovascular and metabolic diseases in adulthood [41,42,43].”

    From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [42]

    In the 'coronary risk factors' section (page not provided), the paper suggests that fetal undernutrition may help explain later coronary heart disease and insulin resistance. It also links being thin at age two with later coronary events, but does not establish nutrient restriction at conception or throughout early childhood, or identify those periods as times of particular tissue sensitivity. (LLM, conf=0.86)

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Authors
Barker, D. J. P., Osmond, C., Forsén, T. J., Kajantie, E., & Eriksson, J. G.
Affiliations
Southampton General Hospital (GB)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2005-10-27
Volume
353
Issue
17
Pages
1802-1809
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa044160
OpenAlex
W2020985812
Cited by
1,517
References
21
Citations by year
2026: 28 · 2025: 33 · 2024: 41 · 2023: 63 · 2022: 48 · 2021: 67 · 2020: 49 · 2019: 52 · 2018: 77 · 2017: 66 · 2016: 87 · 2015: 79 · 2014: 67 · 2013: 115 · 2012: 109
FWCI
68.02
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
coronary artery disease, child growth, low birth weight, body mass index, rapid weight gain, insulin resistance, fasting insulin, coronary risk factors, sex differences
MeSH terms
Aged, Birth Weight, Child, Child, Preschool, Coronary Disease, Female, Growth, Humans, Hyperinsulinism, Infant, Newborn, Male, Middle Aged, Retrospective Studies, Risk Factors, Thinness, Cohort Studies, Weight Gain, Body Mass Index, Proportional Hazards Models

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