The Developmental Origins of Health and Disease in Women from the Michigan Bone Health and Metabolism Study: An Examination with Longitudinal and Intergenerational Data.

Abstract

Fetal and early life experiences may be associated with development of adult chronic disease and effects may extend across generations. Epidemiologists have adapted these concepts to identify risk factors for chronic disease, but studies with longitudinal or intergenerational data are limited. Using data from a cohort study of Caucasian women, aged 24-50 years in 1992 and followed annually for over 15 years, we evaluated whether low and high birth weight women had different adult body composition, carbohydrate metabolism, or lipid trajectories compared to normal birth weight women. We assessed whether longitudinal risk profiles for diabetes or metabolic clustering differed by birth weight. To better understand intergenerational continuity of risk, we evaluated whether pregnancy characteristics across two generations influenced the birth weight of these women’s offspring. High birth weight women had higher adult body composition measures compared to normal birth weight women; however, slopes did not differ, suggesting the higher body composition measures observed among high birth weight women were constant over time. High birth weight women had steeper rates of change in glucose levels, but no differences were observed in lipid, insulin, or insulin resistance levels or in their trajectories over time compared to normal birth weight women. Body composition, carbohydrate metabolism, and lipid trajectories did not differ between low and normal birth weight women and the risk for developing type-2 diabetes or metabolic clustering did not differ by birth weight groups. When we examined the intergenerational effects, we found that women with in utero cigarette smoking exposure had offspring who were an average of 136 grams heavier than women without in utero smoking exposure (p=0.02). Similarly, women born to older mothers had heavier offspring than women born to younger mothers. This dissertation expands our understanding of the relationship between birth weight and trajectories in adult body composition, carbohydrate metabolism, and lipids – known risk factors for many chronic diseases - and provides further support of an intergenerational effect on birth weight. Understanding these relationships contributes to knowledge about chronic disease etiology and can motivate research and interventions aimed at improving reproductive and women’s health and preventing chronic disease.Ph.D.Epidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/77888/1/erillama_1.pd