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American Journal of Epidemiology Advance Access originally published online on April 10, 2009
American Journal of Epidemiology 2009 169(12):1428-1436; doi:10.1093/aje/kwp065
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Birth Weight, Early Weight Gain, and Subsequent Risk of Type 1 Diabetes: Systematic Review and Meta-Analysis

Thomas Harder, Katharina Roepke, Natasha Diller, Yvonne Stechling, Joachim W. Dudenhausen and Andreas Plagemann

Correspondence to Dr. Andreas Plagemann, Clinic of Obstetrics, Division of "Experimental Obstetrics," Charité—University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany (e-mail: andreas.plagemann{at}charite.de).

Received for publication December 10, 2008. Accepted for publication February 26, 2009.

Previous studies suggest that birth weight and weight gain during the first year of life are related to later risk of type 1 diabetes. The authors performed a systematic review and meta-analysis on these associations. Twelve studies involving 2,398,150 persons of whom 7,491 had type 1 diabetes provided odds ratios and 95% confidence intervals of type 1 diabetes associated with birth weight. Four studies provided data on weight and/or weight gain during the first year of life. High birth weight (>4,000 g) was associated with increased risk of type 1 diabetes (odds ratio = 1.17, 95% confidence interval (CI): 1.09, 1.26). According to sensitivity analysis, this result was not influenced by particular study characteristics. The pooled confounder-adjusted estimate was 1.43 (95% CI: 1.11, 1.85). No heterogeneity was found (I2 = 0%) and no publication bias. Low birth weight (<2,500 g) was associated with a nonsignificantly decreased risk of type 1 diabetes (odds ratio = 0.82, 95% CI: 0.54, 1.23). Each 1,000-g increase in birth weight was associated with a 7% increase in type 1 diabetes risk. In all studies, patients with type 1 diabetes showed increased weight gain during the first year of life, compared with controls. This meta-analysis indicates that high birth weight and increased early weight gain are risk factors for type 1 diabetes.

birth weight; diabetes mellitus, type 1; meta-analysis; weight gain

Abbreviations: CI, confidence interval; OR, odds ratio


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C. R. Cardwell and C. C. Patterson
RE: "BIRTH WEIGHT, EARLY WEIGHT GAIN, AND SUBSEQUENT RISK OF TYPE 1 DIABETES: SYSTEMATIC REVIEW AND META-ANALYSIS"
Am. J. Epidemiol., August 15, 2009; 170(4): 529 - 530.
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T. Harder and A. Plagemann
TWO AUTHORS REPLY
Am. J. Epidemiol., August 15, 2009; 170(4): 530 - 531.
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