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Previous Volume 353:1802-1809 October 27, 2005 Number 17 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Gillman, M. W. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

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.

Source Information

From the Developmental Origins of Health and Disease Division (D.J.P.B.) and the Medical Research Council Epidemiology Resource Center (C.O.), University of Southampton, Southampton General Hospital, Southampton, United Kingdom; and the National Public Health Institute, Helsinki (T.J.F., E.K., J.G.E.).

Address reprint requests to Professor Barker at the DOHaD Division, Level F (887), Princess Anne Hospital, Coxford Rd., Southampton SO16 5YA, United Kingdom, or at djpb{at}mrc.soton.ac.uk.

Full Text of this Article

Related Letters:

Childhood Growth and Coronary Events
Chamoun A. J., Curran-Chamoun D. M., Barker D. J.P., Osmond C., Eriksson J. G.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:303-304, Jan 19, 2006. Correspondence

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