—to: Hales CN, Ozanne SE (2003) For Debate: Fetal and early postnatal growth restriction lead to diabetes, the metabolic syndrome and renal failure. Diabetologia 46:1013–1019

Excerpt

To the Editor: In their recent For Debate article, Hales and Ozanne gave an impressive overview of the overwhelming body of data accumulated over the past decade that seems to indicate a causal relationship between low birthweight and later development of the metabolic syndrome X [1]. More specifically, they state that fetal and early postnatal growth restriction lead to diabetes, the metabolic syndrome X and renal failure. However, the authors do not take into account a fundamental concept that is critically related to the pathophysiology of the metabolic syndrome X and its possible relation to low birthweight: obesity is known to be the key feature of human metabolic syndrome X. This factor requires explicit consideration. From a public health perspective, overweight is recognised as the major cause of the dramatic increase in the prevalence of Type 2 diabetes, the metabolic syndrome X, and critical cardiovascular endpoints observed in recent years [2]. To our knowledge, however, no study currently exists that describes an independent association between low birthweight and obesity in later life. Only inconsistent data are available on the risk of obesity in later life in low birthweight subjects, as recently reviewed by Oken and Gillman [3]. From these epidemiological data, it cannot be concluded that low birthweight is an independent risk factor for obesity in later life. …