Birth weight – a risk factor for progression in diabetic nephropathy?

.  Jacobsen P, Rossing P, Tarnow L, Hovind P, Parving H‐H (Steno Diabetes Center, Gentofte, Denmark). Birth weight – a risk factor for progression in diabetic nephropathy? J Intern Med 2003; 253: 343–350. Objectives.  Intrauterine growth retardation, as seen in individuals with low weight at birth,...

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Published in:Journal of internal medicine 2003-03, Vol.253 (3), p.343-350
Main Authors: Jacobsen, P., Rossing, P., Tarnow, L., Hovind, P., Parving, H‐H.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
birth weight
Body Height
Diabetes Mellitus, Type 1 - embryology
Diabetes Mellitus, Type 1 - etiology
Diabetes. Impaired glucose tolerance
Diabetic Nephropathies - embryology
Diabetic Nephropathies - etiology
diabetic nephropathy
Disease Progression
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Fetal Growth Retardation - physiopathology
Follow-Up Studies
glomerular filtration rate
Glomerular Filtration Rate - physiology
Humans
Infant, Low Birth Weight - physiology
Infant, Newborn
Kidney Function Tests
Male
Medical sciences
Regression Analysis
Risk Factors
type 1 diabetes mellitus
weight/length ratio
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Summary:.  Jacobsen P, Rossing P, Tarnow L, Hovind P, Parving H‐H (Steno Diabetes Center, Gentofte, Denmark). Birth weight – a risk factor for progression in diabetic nephropathy? J Intern Med 2003; 253: 343–350. Objectives.  Intrauterine growth retardation, as seen in individuals with low weight at birth, may give rise to a reduction in nephron number. Oligonephropathy has been linked to hypertension and renal disease in adult life. We tested the concept that low weight at birth acts as a risk factor for progression of diabetic nephropathy. Design and subjects.  We performed an observational follow‐up study of 161 (97 men) type 1 diabetic patients with diabetic nephropathy [mean age (SD): 35 (11) years, mean duration of diabetes: 22 (8) years]. All patients had been followed for at least 3 years [median (range): 8 (3–20)] with at least three measurements [9 (3–31)] of glomerular filtration rate (GFR) (51Cr‐EDTA). Information about birth size was obtained from midwife registrations. Settings.  Steno Diabetes Center, a tertiary referral centre. Main outcome measures.  Loss of kidney function according to birth weight and weight/length ratio at birth. Results.  There was no correlation in univariate analysis between birth weight or weight/length ratio and rate of decline in GFR, neither in men nor in women. Furthermore, the 27 patients with birth weights below the 20th centile had a rate of decline in GFR [median (range)] similar to the 134 patients above: 2.6 (−4.7; 9.6) vs. 3.4 (−2.3; 19.3) mL min−1 year−1, respectively (NS). A multiple regression analysis revealed that albuminuria, arterial blood pressure, and haemoglobin A1C during follow‐up showed a significant correlation with the decline in GFR [R2 (adjusted) = 0.34], whereas birth weight and birth weight/length ratio did not. Conclusions.  Our study does not suggest that weight at birth is associated with progression of established diabetic nephropathy in type 1 diabetic patients, whilst several other potential modifiable risk factors were identified.
ISSN:0954-6820
1365-2796
DOI:10.1046/j.1365-2796.2003.01109.x