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Birth weight and risk of type 2 diabetes: A dose‐response meta‐analysis of cohort studies

The association between birth weight and type 2 diabetes mellitus has been debated for several decades. The objective of this systematic review and meta‐analysis was to quantitatively clarify the association between birth weight and risk of type 2 diabetes mellitus based on cohort studies. We searched PubMed, Web of Science, and Embase databases for cohort study articles on the association between birth weight and risk of type 2 diabetes mellitus published up to 1 March 2018. Random effects of generalized least square regression models were used to estimate relative risk (RR). Restricted cubic splines were conducted to model the dose‐response relationship. We included 21 studies (19 articles) involving 1 041 879 individuals and 35 699 cases of type 2 diabetes mellitus, with follow‐up ranged from 6 to 47 years. We identified significant decreasing trend for the highest versus lowest category of birth weight for the association with type 2 diabetes mellitus risk: The risk was reduced by 35% (RR, 0.65; 95% confidence interval [CI], 0.53‐0.81) and by 12% (RR 0.88; 95% CI, 0.85‐0.91) per 500‐g increment in birth weight. Our results showed a dose‐response relationship between birth weight and diabetes risk, which was nonlinear (Pnonlinearity < 0.001) and L‐shaped. With increasing birth weight (<5000 g), the risk of type 2 diabetes mellitus decreased substantially. The association between birth weight and type 2 diabetes mellitus was curvilinear and L‐shaped.