Low birthweight and adult insulin resistance: the "catch-up growth" hypothesis.

Fetal origin of adult diseases Epidemiological studies have shown a close correlation between intrauterine growth retardation (IUGR) and the onset of insulin resistance, non-insulin-dependent diabetes mellitus (NIDDM), hypertension, hyperlipidaemia, and cardiovascular diseases in adult life. To explain this association, the concept of re-programming has been introduced: intrauterine exposure to insuYcient nutrient supply during critical periods of fetal life would permanently aVect the development and function of the endocrine system, leading to metabolic changes, including reduced insulin sensitivity. 6 Although knowledge of the mechanisms involved in the re-programming process might allow new strategies for early prevention of long term metabolic disturbances to be developed, the pathophysiological link between fetal growth impairment and adult diseases is still unclear.