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Birth weight and risk of type 2 diabetes Does body fat play a mediating role? The black women's health study

OBJECTIVETo assess the association of birth weight with incident type 2 diabetes, and the possible mediating influence of obesity, in a large cohort of U.S. black women.RESEARCH DESIGN AND METHODSThe Black Women’s Health Study is an ongoing prospective study. We used Coxproportional hazards models to estimate incidence rate ratios (IRRs) and 95% CIfor categories of birth weight (very low birth weight [<1,500 g], low birth weight[1,500–2,499 g], and high birth weight [‡4,000 g]) in reference to normal birthweight (2,500–3,999 g). Models were adjusted for age, questionnaire cycle, family history of diabetes, caloric intake, preterm birth, physical activity, years of education, and neighborhood socioeconomic status with and without inclusion ofterms for adult BMI.RESULTSWe followed 21,624 women over 16 years of follow-up. There were 2,388 cases of incident diabetes. Women with very low birth weight had a 40% higher risk of disease (IRR 1.40 [95% CI 1.08–1.82]) than women with normal birth weight; women with low birth weight had a 13% higher risk (IRR 1.13 [95% CI 1.02–1.25]). Adjustment for BMI did not appreciably change the estimates.CONCLUSIONSVery low birth weight and low birth weight appear to be associated with increased risk of type 2 diabetes in African American women, and the association does not seem to be mediated through BMI. The prevalence of low birth weight is especially high in African American populations, and this may explain in part the higher occurrence of type 2 diabetes.


Ruiz-Narvaez, E., Palmer, J., Gerlovin, H., Wise, L., Vimalananda, V., & Rosenzweig, J. (2014). Birth weight and risk of type 2 diabetes: Does body fat play a mediating role? The black women's health study. Diabetes Care, 37(9), 2572–2578. DOI: 10.2337/dc14-0731

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