Objective. To examine the relationships between birth weight and body mass index, percent body fat, blood lipids, glycemia, insulin resistance, adipokines, blood pressure, and endothelial function in a cohort of obese adolescents. Design and Methods. Ninety-five subjects aged 10–16 years (mean age 13.5 years) with a body mass index >95th centile (mean [±SEM] 33.0 ± 0.6) were utilized from two prospective studies for obesity prevention prior to any interventions. The mean term birth weight was 3527 ± 64？g (range 1899–4990？g;). Results. Body mass index z-score correlated positively with birth weight ( , ), but not percent body fat. Insulin resistance negatively correlated with birth weight ( , ), as did fasting plasma insulin ( , ); both being significantly greater for subjects of small versus large birth weight (Δ Homeostasis Model Assessment = 2.5 and Δ insulin = 10？pmol/L for birth weight <2.5？kg versus >4.5？kg). Adiponectin, but not leptin, blood pressure z-scores or peripheral arterial tomography values positively correlated with birth weight ( , ). Conclusions. Excess body mass index in obese adolescents was positively related to birth weight. Birth weight was not associated with cardiovascular risk factors but represented a significant determinant of insulin resistance. 1. Introduction Childhood obesity in Canada, as in other developed countries, has increased dramatically with 29% of children being overweight or obese in 2007 compared to 15% in 1978 [1]. Obesity in childhood is a strong indicator of future obesity in adulthood and also confers a high risk for future development of type 2 diabetes (T2D) and cardiovascular disease [2, 3]. The future risk of adult T2D is greater in adolescents who demonstrate insulin resistance [4]. Small-for-gestational age (SGA, <10th percentile birth weight) and large-for-gestational age (LGA, >90% percentile) birth weight can both confer an increased risk of adolescent and adult obesity, insulin resistance, metabolic syndrome, and T2D in adulthood [5, 6]. A meta-analysis of 20 studies showed that birth weight greater than 4？kg increased the risk of obesity (odds ratio 2.1), but being SGA did not, although the majority of the studies analyzed considered children prior to adolescence [7]. However, it is not clear whether consideration of birth weight is of practical relevance in the management of the individual obese child at risk of the development of metabolic or cardiovascular disease. The association between LGA, often with macrosomia, and adolescent and adult obesity, as well as the associated increased risk
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