Published Online
on October 18, 2004

A more recent version of this article appeared on December 1, 2004

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Submitted on June 9, 2004
Revised on June 28, 2004

Birth Weight Is Inversely Correlated to Adult Systolic Blood Pressure and Pulse Pressure in Type 1 Diabetes

Johan Fagerudd; Carol Forsblom; Kim Pettersson-Fernholm; Markku Saraheimo; Johan Wadén; Mats Rönnback; Milla Rosengård-Bärlund; Clas-Göran af Björkesten; Lena Thorn; Maija Wessman; Per-Henrik Groop^*; on behalf of the FinnDiane Study Group

From Folkhälsan Institute of Genetics (J.F., C.F., K.P.-F., M.S., J.W., M.R., M.R.-B., C.-G.B., L.T., M.W., P.-H.G.), Folkhälsan Research Center; Department of Clinical Chemistry (M.W.); The Finnish Genome Center (M.W.), University of Helsinki; and Department of Medicine (J.F., C.F., K.P.-F., M.S., J.W., M.R., M.R.-B., C.-G.B., L.T., M.W., P.-H.G.), Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.

^* To whom correspondence should be addressed. E-mail: per-henrik.groop{at}helsinki.fi.

Abstract--In the general population, there is an inverse relationship between birth weight and adult systolic blood pressure. Because blood pressure in diabetic patients at least in part seems to be regulated by different mechanisms than in nondiabetic subjects, it is not known whether a similar correlation exists in diabetic individuals. Therefore, we obtained data on birth weight from original birth certificates in 1543 type 1 diabetic patients. Blood pressure was measured auscultatorily on a single occasion. In the 1225 patients born at term (after 37 weeks of gestation), the age- and sex-adjusted regression coefficients between systolic blood pressure and birth weight was -1.90 mm Hg/kg (95% confidence interval [CI], -3.71 to -0.09). The finding remained unchanged after adjustment for body mass index, current smoking, duration of diabetes, social class, antihypertensive therapy, glomerular filtration rate, glycemic control, and elevated albuminuria. The regression coefficient between birth weight and pulse pressure was of a similar magnitude. The age-adjusted regression coefficient between systolic blood pressure and birth weight seemed stronger in females (-3.34 mm Hg/kg; 95% CI, -6.06 to -0.62) than in males (-0.42 mm Hg/kg; 95% CI, -2.80 to 1.95), although this difference was not statistically significant. As a new finding, we report an inverse relationship between weight at birth and systolic blood pressure and pulse pressure in adult type 1 diabetic patients. Given the deleterious effects of elevated arterial blood pressure in diabetes, the impact of intrauterine growth retardation on the development of end-organ damage needs to be clarified.

Key words: diabetes mellitus • blood pressure • epidemiology

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