Low birth weight in combination with catch-up growth predicts the occurrence of the metabolic syndrome in men at late middle age: the Atherosclerosis and Insulin Resistance study

Objectives. To study the combined effects of a low birth weight and a pronounced weight increase up to early adulthood on the presence of cardiovascular risk factors constituting the metabolic syndrome in late middle age. Design and setting. A structured sample of 396 men, 58 years old from the general population. Birth weight and weight at 18 years were obtained from medical records and registers. Main outcome measures. Body mass index (BMI), waist : hip ratio (WHR), blood pressure, serum concentrations of insulin, triglycerides, HDL cholesterol and LDL particle size at age 58 years. Results. The ratio between weight at age 18 years and birth weight correlated with a number of characteristics at age 58 years: BMI (r = 0.24, P < 0.001), WHR (r = 0.24, P < 0.001), diastolic blood pressure (r = 0.13, P < 0.05), insulin (r = 0.14, P < 0.01), triglycerides (r = 0.10, P < 0.05), HDL cholesterol (r = -0.13, P < 0.01) and LDL particle size (r = -0.17, P < 0.05). The metabolic syndrome, according to current definitions, were more common at the age of 58 years in the third tertile of the weight at 18/birth ratio, than in the other tertiles (P = 0.008). Conclusions. The interaction between a low birth weight and an accelerated catch-up growth to early adulthood is associated with the occurrence of the metabolic syndrome in the late middle age. These findings are in accord with the concept that the effects of genes are conditioned by fetal growth, and that the effects of a small body size at birth are conditioned by growth during childhood and by environmental factors in childhood and adult life.