Biomedical subjects

D A Lawlor

Publications and source records attributed to D A Lawlor.

At least 19 recordsLinked to original sources

PubMed2007

How many cases of Type 2 diabetes mellitus are due to being overweight in middle age? Evidence from the Midspan prospective cohort studies using mention of diabetes mellitus on hospital discharge or death records.

AIMS: To relate body mass index (BMI) in middle age to development of diabetes mellitus. METHODS: Participants were 6927 men and 8227 women from the Renfrew/Paisley general population study and 3993 men from the Collaborative occupational study. They were aged 45-64 years and did not have reported diabetes mellitus. Cases who developed diabetes mellitus, identified from acute hospital discharge data and from death certificates in the period from screening in 1970-1976 to 31 March 2004, were related to BMI at screening. RESULTS: Of Renfrew/Paisley study men 5.4%, 4.8% of women and 5% of Collaborative study men developed diabetes mellitus. Odds ratios for diabetes mellitus were higher in the overweight group (BMI 25 to < 30 kg/m(2)) than in the normal weight group (BMI 18.5 to < 25 kg/m(2)) and highest in the obese group (BMI >or= 30 kg/m(2)). Compared with the normal weight group, age-adjusted odds ratios for overweight and obese Renfrew/Paisley men were 2.73 [95% confidence interval (CI) 2.05, 3.64] and 7.26 (95% CI 5.26, 10.04), respectively. Further subdividing the normal, overweight and obese groups showed increasing odds ratios with increasing BMI, even at the higher normal level. Assuming a causal relation, around 60% of cases of diabetes could have been prevented if everyone had been of normal weight. CONCLUSIONS: Overweight and obesity account for a major proportion of diabetes mellitus, as identified from hospital discharge and death records. With recent increases in the prevalence of overweight, the burden of disease related to diabetes mellitus is likely to increase markedly. Primordial prevention of obesity would be a major strategy for reducing the incidence of diabetes mellitus in populations.

Age Factors↗

PubMed2006

Obesity and use of acute hospital services in participants of the Renfrew/Paisley study.

BACKGROUND: Because overweight and obesity are associated with comorbidities, increasing levels of overweight and obesity may impact on hospital use. METHODS: Body mass index (BMI) in middle age was related to acute hospital use in 7036 men and 8327 women from the Renfrew/Paisley prospective cohort study in Scotland. Participants in this general population study were examined between 1972 and 1976 when aged 45-64 years. Acute hospital admissions and bed days per 1000 person-years were calculated by the World Health Organization BMI categories in the follow-up period to 31 March 2004. RESULTS: Underweight and normal weight men had lower-than-expected admission rates, and overweight and obese men had higher-than-expected admission rates. Obese men had higher-than-expected bed day rates. For women, there was a U-shaped relationship with admission rate, with normal weight women having the lowest admission rate and underweight and obese women having similar high rates. Underweight and obese women had higher-than-expected bed day rates. CONCLUSIONS: Participants who were obese in midlife had more-than-expected acute hospital admissions and in particular more bed days. With levels of obesity increasing since this study was started in the 1970s, if these patterns persist, there may be increasing demand on health service resources.

Body Mass Index↗

PubMed2006

The associations of birthweight, gestational age and childhood BMI with type 2 diabetes: findings from the Aberdeen Children of the 1950s cohort.

AIMS/HYPOTHESIS: The aim of this study was to examine the associations of birthweight, gestational age and childhood BMI (assessed at a mean age of 5 years) with a self-report of a doctor diagnosis of diabetes in middle age. METHODS: We studied a birth cohort of 5,793 individuals who were born between 1950 and 1956 in Aberdeen, Scotland, and who responded to a questionnaire administered in 2000. RESULTS: Birthweight and gestational age were inversely associated with diabetes. These associations remained with additional adjustment for indicators of childhood and adult socioeconomic position, maternal complications of pregnancy, adult smoking, adult BMI and simultaneous adjustment for each other: the adjusted odds ratio per unit increase in birthweight z score was 0.73 (95% CI 0.60-0.88), the odds ratio per week increase in gestational age was 0.91 (95% CI 0.82-1.00) and odds ratio for preterm birth was 2.04 (94% CI 1.18-3.53). The positive association of childhood BMI with diabetes was attenuated on adjustment for adult BMI. CONCLUSIONS/INTERPRETATION: In this population, who were born in the 1950s, poor intrauterine growth and preterm birth are associated with an increased risk of diabetes.

Birth Weight↗

PubMed2006

The detection, treatment and control of high blood pressure in older British adults: cross-sectional findings from the British Women's Heart and Health Study and the British Regional Heart Study.

Among older people, the detection and control of hypertension is particularly important to reduce cardiovascular disease risk. This cross-sectional survey aimed to describe the detection, treatment and control of hypertension in older British adults. A total of 3059 women and 3007 men aged 60-79 years were randomly selected from general practice age/sex registers in 24 British towns and examined from 1998 to 2001. Of these, 52.6% women and 47.9% men had at least one indicator of hypertension (high blood pressure on examination, or taking antihypertensive medication or recalled a doctor diagnosis of high blood pressure). Among women, 50% of those with any indication of hypertension were on treatment and 29% were well controlled, and among men 45% were on treatment and 16% were well controlled. With the exception of alcohol use in men (adjusted odds ratio 0.67 (0.46, 0.98)), socioeconomic factors, area of residence and behavioural risk factors were not associated with good control among those with hypertension in either sex. Of those on treatment, 20.7% of women and 28% of men were on two classes of antihypertensive medication and 3.5 and 4.9%, respectively, were on three or more classes of antihypertensive medication. Among those with a doctor diagnosis of hypertension and taking antihypertensive medication, the proportion with well controlled blood pressure did not differ between those on more than one antihypertensive and those on just one in either sex. We conclude that targets of good control are rarely met in older individuals, who would benefit from the associated reduction in cardiovascular disease risk.

Age Factors↗

PubMed2006

Childhood intelligence, educational attainment and adult body mass index: findings from a prospective cohort and within sibling-pairs analysis.

BACKGROUND: The mechanisms underlying the observed association of childhood intelligence with body mass index (BMI) are unclear and few studies of this association have been prospective in design. METHODS: Prospective study in a birth cohort of 5467 individuals who were born in Aberdeen, Scotland between 1950 and 1956 and who responded to a follow-up survey in 2001. Comparison of associations within sibling pairs of the same family to associations between different families in 643 sibling pairs (1286 individuals) who are participants in the main cohort. RESULTS: Childhood intelligence (age 7 years) and educational attainment were both inversely associated with adult BMI (mean age 48 years): the sex- and age-adjusted mean change in adult BMI per s.d. of intelligence was -0.35 kg/m(2) (95% CI: -0.49, -0.21 kg/m(2)) and per unit increase in educational category (seven categories) was -0.28 kg/m(2) (95% CI: -0.34, -0.22). On adjustment for education the association between childhood intelligence and adult BMI attenuated to the null (-0.03 kg/m(2) (-0.19, 0.13 kg/m(2))); other potential confounding or mediating factors had little or only modest effects on this association. The association between education and adult BMI was not affected by adjustment for childhood intelligence or other potential covariates. The within sibling-pair effect of education on adult BMI (-0.06 kg/m(2) (95% CI: -0.26, 0.14)) was weaker than the effect between different families (-0.37 kg/m(2) (95%CI: -0.58, -0.17)), P-value for difference of within sibling and between family effect=0.03. CONCLUSIONS: The association of childhood intelligence with adult BMI is attenuated to the null on adjustment for educational attainment, whereas the association of educational attainment with adult BMI appears to be independent of childhood intelligence and other measured covariates. However, our family analyses suggest that fixed family and neighbourhood factors, which are closely matched in siblings of a similar age, explain much of the association between greater educational attainment and lower adult BMI.

Body Mass Index↗

PubMed2006

Cardiovascular disease risk assessment in older women: can we improve on Framingham? British Women's Heart and Health prospective cohort study.

OBJECTIVES: To develop a cardiovascular risk assessment tool that is feasible and easy to use in primary care (general practice (GP) model). DESIGN: Prospective cohort study. SETTING: 23 towns in the United Kingdom. PARTICIPANTS: 3582 women aged 60 to 79 years who were free of coronary heart disease (CHD) at entry into the British Women's Heart and Health Study. MAIN OUTCOME MEASURES: Predictive performance of a GP model compared with the standard Framingham model for both CHD and cardiovascular disease (CVD). RESULTS: The Framingham tool predicted CHD events over 5 years accurately (predicted 5.7%, observed 5.5%) but overpredicted CVD events (predicted 10.5%, observed 6.8%). In higher-risk groups, Framingham overpredicted both CHD and CVD events and was poorly calibrated for this cohort. Including C-reactive protein and fibrinogen with standard Framingham risk factors did not improve discrimination of the model. The GP model, which used age, systolic blood pressure, smoking habit and self-rated health (all of which can be easily obtained in one surgery visit) performed as well as the Framingham risk tool: area under the receiver operating curve discrimination statistic was 0.66 (95% confidence interval (CI) 0.62 to 0.70) for CHD and 0.67 (95% CI 0.64 to 0.71) for CVD compared with 0.65 (95% CI 0.61 to 0.68) and 0.66 (95% CI 0.62 to 0.69) for the corresponding Framingham models. CONCLUSIONS: An alternative risk assessment based on only a simple routine examination and a small number of pertinent questions may be more useful in the primary care setting. This model appears to perform well but needs to be tested in different populations.

Cardiovascular Diseases↗

PubMed2006

Genotype of galectin 2 (LGALS2) is associated with insulin-glucose profile in the British Women's Heart and Health Study.

AIMS/HYPOTHESIS: It has been suggested that the gene encoding lymphotoxin-alpha (LTA) is associated with insulin resistance, and genetic association studies in the LTA region offer some support for this. However, LTA is in linkage disequilibrium with both the HLA gene cluster and the gene encoding TNF-alpha, making inferences about causality difficult. In this study, we used the galectin 2 (LGALS2) genotype, which affects LTA secretion but is located on another chromosome than the HLA gene cluster or TNF, to examine the relationship between the LTA pathway and traits of the metabolic syndrome. SUBJECTS: A cross-sectional genetic association study was carried out in 3,272 British women of European origin who were aged 60 to 79 years and were randomly selected from the community. RESULTS: Fasting plasma glucose and serum insulin were statistically significantly associated with LGALS2 rs7291467, with this association being independent of BMI and WHR. The mean difference in fasting insulin per minor allele was -4% (p=0.01 for trend by allele) and the mean per minor allele difference in fasting glucose was -2% (p=0.02 for trend by allele). When women with known diabetes were excluded from the analyses the findings did not differ from those for the whole cohort. CONCLUSIONS/INTERPRETATION: Our findings for the physically unlinked LGALS2, invite further study of LGALS2 specifically and the LTA pathway generally for their influence on glucose-insulin regulation.

Aged↗

PubMed2006

Changing epidemiology of bacterial meningitis among adults in England and Wales 1991-2002.

We examined the epidemiology of community-acquired bacterial meningitis among adults in England and Wales between 1991 and 2002. Among 3169 cases, meningococcal infection was predominant among young adults and pneumococcal meningitis among older adults. Whilst infection due to most causes decreased, the incidence of tuberculous (TB) meningitis doubled over the 12 years. The mortality rate among meningococcal and pneumococcal infections fell from 0.45/10(5) to 0.31/10(5) (P=0.0001). This study demonstrates important changes in the epidemiology of bacterial meningitis among UK adults. Improvements in clinical management, childhood vaccination programmes and the re-emergence of tuberculosis are likely to be drivers of these changes.

Adolescent↗

PubMed2006

Lifecourse weight patterns and adult-onset diabetes: the Glasgow Alumni and British Women's Heart and Health studies.

OBJECTIVE: To examine the association between body weight measures across the lifecourse and the risk of adult-onset diabetes. METHODS: We analysed data from the Glasgow Alumni Cohort and the British Women's Heart and Health Study (BWHHS). The former included 5,571 men and women who had height and weight measured at university, and reported birthweight, mid- and later-life weight in a postal questionnaire. The BWHHS analysis included 4,280 women who had height and weight measured in later adulthood and recalled their birthweight and early adult height and weight. Adult-onset diabetes was defined as doctor-diagnosed disease after age 30, either self-reported or abstracted from medical records. RESULTS: Thirty nine women and 209 men (Glasgow Alumni study) and 314 women (BWHHS) had diabetes. Those with diabetes had lower mean birthweight than those without, although the differences were small. Individuals with diabetes were also shorter and heavier at all ages than those without diabetes. Being overweight during at least one time period in adult life was associated with an increased risk of diabetes, compared to those who were never overweight. While there was no age at which being overweight was particularly detrimental, the risk associated with being overweight was cumulative across the lifecourse. CONCLUSIONS: Being overweight at any point during life is associated with an increased risk of adult-onset diabetes. The cumulative nature of this association reinforces the need to prevent the development of excess weight at an early age to reduce diabetes prevalence in coming decades.

Adolescent↗

PubMed2006

The thermolabile variant of MTHFR is associated with depression in the British Women's Heart and Health Study and a meta-analysis.

Low dietary folate intake has been implicated as a risk factor for depression. However, observational epidemiological studies are plagued by problems of confounding, reverse causality and measurement error. A common polymorphism (C677T) in MTHFR is associated with methyltetrahydrofolate reductase (MTHFR) activity and circulating folate and homocysteine levels and offers insights into whether the association between low folate and depression is causal. We genotyped this polymorphism in 3,478 women in the British Women's Heart and Health Study. In these women, we looked at the association between genotype and three indicators of depression; ever diagnosed as depressed, currently taking antidepressants and the EuroQol mood question. We also carried out a systematic review and meta-analysis of all published studies which have looked at the association between MTHFR C677T genotype and depression. In the British Women's Heart and Health Study, we found evidence of an increased risk of ever being diagnosed as depressed in MTHFR C677T TT individuals compared with CC individuals, odds ratio (OR) 1.35(95% CI: 1.01, 1.80). Furthermore, we identified eight other studies, which have examined the association between depression and MTHFR C677T. We were able to include all of these studies in our meta-analysis together with our results, obtaining an overall summary OR of 1.36 (95% CI: 1.11, 1.67, P=0.003). Since this genotype influences the functioning of the folate metabolic pathway, these findings suggest that folate or its derivatives may be causally related to risk of depression.

Aged↗

PubMed2006

Do children from an inner city British school meet the recommended levels of physical activity? Results from a cross sectional survey using objective measurements of physical activity.

Questionnaire surveys suggest physical activity levels in children are low, particularly among children from deprived areas. Using accelerometers, it was found that children from a deprived inner city school were active at recommended levels and had similar levels of activity to children in other studies from more affluent populations. However, this finding was dependent on the threshold used to define moderate activity.

Child↗

PubMed2005

Does the new International Diabetes Federation definition of the metabolic syndrome predict CHD any more strongly than older definitions? Findings from the British Women's Heart and Health Study.

AIMS/HYPOTHESIS: We compared the associations between three definitions of the metabolic syndrome and CHD risk. The definitions studied were the new International Diabetes Federation (IDF) definition, and those of the World Health Organization (WHO) and the National Cholesterol Education Programme (NCEP). Our aim was to determine whether the magnitudes of the associations for any of the syndrome definitions are greater than for the individual components. MATERIALS AND METHODS: A prospective cohort study of a random sample of 3,589 British women who were aged 60-79 years and free of CHD at baseline was performed. Among these women there were 194 incident cases of CHD (40 of them fatal) during 15,778 woman-years of follow-up. RESULTS: Insulin resistance (homeostasis model assessment), triglyceride levels, systolic blood pressure, waist and waist-to-hip ratio were positively and linearly associated with CHD risk; HDL cholesterol was inversely associated with risk. All three definitions of the metabolic syndrome were modestly and similarly (to each other) associated with CHD risk. The age-adjusted hazard ratio (95% CI) was 1.32 (1.03, 1.70) for IDF syndrome, 1.45 (1.00, 2.10) for WHO syndrome, and 1.38 (1.00, 1.93) for NCEP syndrome. Adjustment for smoking, inactivity and life-course socioeconomic position resulted in attenuation of these associations to 1.25 (0.96, 1.61), 1.31 (0.90, 1.90) and 1.27 (0.90, 1.79), respectively. The magnitudes of the associations for individual components of the syndrome were similar to those for any of the syndrome definitions. CONCLUSIONS/ INTERPRETATION: The metabolic syndrome, defined by any of the three methods, is only modestly associated with CHD risk in this study of older women. Life-course socioeconomic position appears to be an important confounder in the association of the metabolic syndrome with CHD risk.

Aged↗

PubMed2005

Association of birth weight with adult lung function: findings from the British Women's Heart and Health Study and a meta-analysis.

BACKGROUND: The aim of this study was to examine the associations between birth weight and lung function in a cohort of women aged 60-79 years and to combine these results with those from other published studies in a systematic review and meta-analysis. METHODS: The associations of self-reported birth weight with adult lung function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and forced expiratory flow rate during mid expiration (FEF(25-75)), all measured using standard procedures, were assessed in a cross sectional study of 2257 British women aged 60-79 years. A detailed literature search was used to identify all published studies of the association, and meta-analysis was used to pool the results from our study and all published studies. RESULTS: There were positive linear associations between birth weight and all three measures of lung function in simple age and examining nurse adjusted regression models. However, with adjustment for height (squared), all three associations attenuated towards the null: adjusted (age, nurse, height2) change in FEV1 per 1 kg birth weight was 0.01 l (95% CI -0.02 to 0.04); in FVC was 0.02 l (95% CI -0.02 to 0.07), and in FEF(25-75) was 0.00 l (95% CI -0.04 to 0.04). Further adjustment for life course socioeconomic position, adult body mass index, and smoking did not alter these associations. The results were similar among life long non-smokers and those who had ever smoked. A meta-analysis of eight studies of adults suggested that there was a positive association between birth weight and FEV1: pooled increase in FEV1 per 1 kg in birth weight 0.048 l (95% CI 0.026 to 0.070) adjusted for age, smoking, and height (or height squared). There was no evidence of small study bias in this meta-analysis. CONCLUSIONS: There is a modest positive association between birth weight and lung function which indicates that intrauterine factors might have a role in lung development.

Aged↗

PubMed2005

Is being overweight associated with behavioural problems in childhood and adolescence? Findings from the Mater-University study of pregnancy and its outcomes.

AIMS: To examine the associations between being overweight and behavioural problems at ages 5 and 14. METHODS: Birth cohort study of 2875 individuals who were born in Brisbane between 1981 and 1984 and who were followed up at ages 5 and 14 years. Behavioural problems were defined as scoring above the 90th centile on Achenbach's child behavioural checklist. RESULTS: In cross-sectional analyses there was no association between being overweight and behavioural problems in either females at age 5. At age 14 females who were overweight were more likely than those who were normal weight to experience behavioural problems. However, there was no association between being overweight and behavioural problems at age 14 among males. The prevalence of behavioural problems increased linearly across the distribution of body mass index in females at age 14. In prospective analyses, among participants who had no behavioural problems at age 5, there was no association between being overweight at age 5 and behavioural problems at age 14 in either sex. Females who were overweight at age 5 and normal weight at age 14 had reduced odds of behavioural problems at age 14. CONCLUSIONS: Among adolescent females there is a positive linear association between body size and behavioural problems. However, no such association was found in adolescent males, or in either sex at age 5 years, and in prospective analyses being overweight at age 5 was not associated with behavioural problems in either sex at age 14.

Adolescent↗

PubMed2005

Family and early life factors associated with changes in overweight status between ages 5 and 14 years: findings from the Mater University Study of Pregnancy and its outcomes.

OBJECTIVE: To describe different patterns of overweight status between ages 5 and 14 y and examine the role of modifiable family and early life characteristics in explaining different patterns of change between these two ages. DESIGN: A population-based prospective birth cohort. SUBJECTS: A total of 2934 children (52% males) who were participants in the Mater-University study of pregnancy, Brisbane, and who were examined at ages 5 and 14 y. MAIN OUTCOME MEASURES: Four patterns of change in overweight/obesity status between ages 5 and 14 y: (i) normal at both ages; (ii) normal at 5 y and overweight/obese at 14 y; (iii) overweight/obese at 5 y and normal at 14 y; (iv) overweight/obese at both ages. RESULTS: Of the 2934 participants, 2018 (68.8%) had a normal body mass index (BMI) at ages 5 and 14 y, 425 (14.5%) changed from a normal BMI at age 5 y to overweight or obese at age 14 y, 175 (6.0%) changed from being overweight or obese at age 5 y to normal weight at age 14 y and 316 (10.8%) were overweight or obese at both ages 5 and 14 y. Girls were more likely to make the transition from overweight or obese at age 5 y to normal at 14 y than their boy counterparts. Children whose parents were overweight or obese were more likely to change from having a normal BMI at age 5 y to being overweight at 14 y (fully adjusted RR: 6.17 (95% CI: 3.97, 9.59)) and were more likely to be overweight at both ages (7.44 (95% CI: 4.60, 12.02)). Birth weight and increase in weight over the first 6 months of life were both positively associated with being overweight at both ages. Other explanatory factors were not associated with the different overweight status transitions. CONCLUSIONS: Parental overweight status is an important determinant of whether a child is overweight at either stage or changes from being not overweight at 5 y to becoming so at 14 y.

Adolescent↗

PubMed2005

Prevalence of undiagnosed Type 2 diabetes and impaired fasting glucose in older British men and women.

AIM: To estimate the prevalence of undiagnosed diabetes and impaired fasting glucose in older British men and women, using the 1999 World Health Organization (WHO) thresholds based on fasting glucose measurements. METHODS: Participants in the British Regional Heart Study and the British Women's Heart and Health Study were selected from one socially representative general practice in 24 British towns. Included in this analysis were 3736 men and 3642 women aged 60-79 years (predominantly white), who provided a single fasting blood sample at a clinical examination between 1998 and 2001, and who had no previous diagnosis of diabetes. RESULTS: Two hundred and eleven men (5.7%) and 190 women (5.2%) had a fasting blood glucose level consistent with the WHO threshold for a diagnosis of diabetes (> or = 7.0 mmol/l), whilst a further 667 men (17.9%) and 642 women (17.6%) had impaired fasting glucose levels (6.1 < or = 7 mmol/l). When analyses were restricted to subjects who had fasted for at least 8 h, and whose blood sample was taken before 12.00 h, the predicted prevalence of undiagnosed diabetes (based on two separate measurements) was 6.7% in men and 6.0% in women. The predicted prevalence of impaired fasting glucose (based on two separate measurements) was approximately 20% in both sexes. CONCLUSIONS: More than one-fifth of older white British men and women have either undiagnosed diabetes or impaired fasting glucose according to new WHO criteria. Strategies for the primary and secondary prevention of Type 2 diabetes among older individuals are urgently needed.

Aged↗

PubMed2005

Avoiding milk is associated with a reduced risk of insulin resistance and the metabolic syndrome: findings from the British Women's Heart and Health Study.

OBJECTIVE: To examine the association of milk consumption with insulin resistance and the metabolic syndrome. METHODS: The association was examined in 4024 British women aged 60-79 who were randomly selected from primary care centres in 23 towns. RESULTS: Women who never drank milk had lower homeostasis model assessment insulin resistance (HOMA) scores, triglyceride concentrations and body mass indices, and higher high-density lipoprotein (HDL)-cholesterol concentrations, than those who drank milk. The age-adjusted odds ratio for the metabolic syndrome comparing non-milk drinkers with drinkers was 0.55 (0.33, 0.94), which did not attenuate with adjustment for potential confounders. Diabetes was less common in non-milk drinkers. CONCLUSION: Individuals who do not drink milk may be protected against insulin resistance and the metabolic syndrome. However, randomized controlled trials are required to establish whether milk avoidance is causally associated with these outcomes.

Aged↗

PubMed2005

The association of birthweight and contemporary size with insulin resistance among children from Estonia and Denmark: findings from the European Youth Heart Study.

OBJECTIVES: To assess the associations of birthweight, contemporary body mass index and height with insulin resistance in children. DESIGN: Cross-sectional study. PARTICIPANTS: From Estonia (n = 1174) and Denmark (n = 1018), 2192 school children aged 9 and 15 years were randomly selected. MAIN OUTCOMES: Insulin resistance (homeostasis model assessment), triglyceride levels, high-density lipoprotein cholesterol and systolic blood pressure. RESULTS: There was an inverse association between birthweight and insulin resistance and a positive association between contemporary body mass index and insulin resistance. With adjustment for maternal and paternal educational level, income, smoking and body mass index, an increase of one unit of sex, age and country standardized body mass index z-score was associated with a 5% (95% CI: 2, 7%) increase in homeostasis model assessment (HOMA) score and a one-unit z-score increase in birthweight with a 2% (95% CI: 0, 5%) decrease in HOMA score. In the 9-year-old age group, height was positively associated with insulin resistance [for a one-unit increase in height z-score HOMA score increased by 30% (95% CI: 14, 50%)], but in the 15-year-old age group there was no association between height and insulin resistance (4% (95% CI: -5, 14%), P for interaction with age group = 0.001). For both ages, those in the lowest third of the birthweight distribution and highest third of the body mass index distribution were most insulin resistant and, among 9-year olds, those in the lowest third of the birthweight distribution and highest third of the height distribution were most insulin resistant. Birthweight was only inversely associated with systolic blood pressure when adjustment was made for either contemporary body mass index or height and there was no association between birthweight and high-density lipoprotein or triglyceride concentrations. CONCLUSIONS: Taken together, these results suggest that a slow intrauterine growth trajectory and/or a fast post-natal growth trajectory is associated with greater insulin resistance in childhood.

Adolescent↗