Low birth weight and postnatal catch-up growth have been associated with an increased risk of type 2 diabetes. In order to further examine this issue, Leunissen et al. examined the relative contribution of birth and adult size, body composition, and waist-to-hip ratio to insulin sensitivity and disposition index (insulin sensitivity x insulin secretion), both risk factors for type 2 diabetes, in young adulthood. This study of 136 young adults revealed that adult fat mass was the only significant predictor of insulin sensitivity in young adulthood, while birth length and birth weight were not. Moreover, analysis of four subgroups [born small for gestational age with short adult height (SGA-S), born small for gestational age with catch-up growth resulting in a normal adult height (SGA-CU), born appropriate for gestational age with growth retardation resulting in a short adult height (ISS), and born appropriate for gestational age with a normal adult height (controls)] showed that SGA-CU subjects had significantly lower insulin sensitivity compared with controls after correction for age, gender, adult body size, and fat mass. Furthermore, none of the variables had a significant influence on disposition index, and there was no significant difference in disposition index between the subgroups. Thus, results of this study indicate that higher body fat mass in young adulthood is associated with reduced insulin sensitivity, independent of birth size. In light of this, the authors stressed that it is important for parents to be aware of the risks of fat accumulation in children, independent of birth size or growth during childhood. They also proposed that children at increased risk for fat accumulation, such SGA-CU subjects, need to be monitored regularly in the primary health care system.
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