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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2001 Sep 1;92(5):340–344. doi: 10.1007/BF03404975

From “Thrifty Genotype” to “Hefty Fetal Phenotype”: The Relationship Between High Birthweight and Diabetes in Saskatchewan Registered Indians

Roland F Dyck 15,25,✉, Helena Klomp 15, Leonard Tan 25
PMCID: PMC6979700  PMID: 11702485

Abstract

Background: Intrauterine factors have been implicated in the pathogenesis of Type 2 diabetes mellitus (T2DM).

Methods: In a 1:1 matched pairs case-control study, high and low birthweight (HBW, LBW) rates in Saskatchewan Registered Indian (RI) diabetic cases were compared with corresponding rates in RI without diabetes, and non-RI people with and without diabetes.

Results: Birthweights were available for 73% of the 1,366 cases and 3 × 1,366 controls. A greater proportion of RI diabetics were born with HBW (>4000 grams) compared to RI non-diabetics (16.2% vs 10.7%; p<0.01). There was a significant association between HBW (but not LBW [<2500 grams]) and diabetes for RI people (OR 1.63 [95% CI 1.20, 2.24]), which was stronger for RI females and strengthened progressively from mid to late 20th century.

Interpretation: Certain causes of HBW may predispose to subsequent development of T2DM in Canadian Aboriginal people (“hefty fetal phenotype” [“hefty fetal type”] hypothesis). Programs that optimize healthy pregnancies could reduce T2DM incidence in future generations.

Footnotes

This research was supported by a grant from the Health Services Utilization and Research Commission (HSURC) of Saskatchewan.

This study is based in part on data provided by the Saskatchewan Department of Health. The interpretations and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Department of Health.

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