Low birth weight: a possible risk factor also for liver diseases in adult life? M. M. Donma, O. Donma Ministry of Health, Suleymaniye Education and Research Hospital, Turkey Istanbul University, Istanbul, Turkey Summary Birth weight is a popular topic, because it is precisely recorded, a major determinant of infant survival, associated with infant mortality, and health outcomes later in life. Low birth weight (LBW) is a predisposing factor for metabolic abnormalities such as atherosclerosis, renal disease, non-insulin diabetes mellitus, asthma, low IQ, hypertension, obesity, psychological distress. They have all been reported to be more common among those who were small at birth. Due to lack of studies suggesting a linkage between LBW and diseases of liver; evidences, which support the hypothesis on the creation of a link between LBW, an indicator of unfavourable intrauterine environment, and liver diseases emerging in the adult life, and possible direct associations of LBW with liver diseases, e.g., hepatitis, non-alcoholic fatty liver disease, cirrhosis, hepatoblastoma, or hepatocellular carcinoma were discussed. The associations between LBW and hepatitis vaccination as well as paediatric parental nutrition were also noted. ª 2003 Elsevier Ltd. All rights reserved. BIRTH WEIGHT, TISSUE-ORGAN GROWTH AND DISEASES IN ADULT LIFE Birth weight is the most important factor among other major neonatal characteristics on body and organ growth capacity, which affects infant growth in post- natal period. The unfavourable intrauterine environ- ment has implications on the adult life. Low birth weight (LBW), an indicator of unfavourable intrauter- ine environment, is a predisposing factor for meta- bolic abnormalities such as atherosclerosis, renal disease, non-insulin diabetes mellitus (NIDDM), asthma, low IQ, hypertension, obesity, psychological distress (1–7). ASSOCIATIONS OF LBW WITH CARDIOVASCULAR, RENAL, ENDOCRINE, CENTRAL NERVOUS SYSTEM DISEASES LBW is introduced as one of the new risk factors of atherosclerosis. LBW infants have an increased risk of cardiovascular diseases in later life (2,3). LBW is reported to increase the risk of the early onset of end-stage renal disease, and it is suggested that an adverse environment in utero impairs kidney development (4). Studies have also showed that part of the risk of adult hypertension is set in fetal life. LBW infants tend to have higher blood pressure in later life. Accelerated weight gain as well as formula feeding in early childhood adds to this risk, which is partly mediated through the pre- diction of adult fatness (5,6,8). LBW appears to be associated with an increased risk of coronary heart disease(CHD) and also with its risk factors, including hypertension and NIDDM (1,2,5) LBW is associated with increased cardiovascular and meta- bolic disorders in adult life. The link between LBW and adult glucose intolerance and blood pressure elevation occurs in young adults (9). 435 Accepted 26 March 2003 Correspondence to: Assoc. Prof. Dr. Mustafa Metin Donma MD, Paediatrician, 11. Kısım, MESA Villa No: 22, Atak€ oy 34750, Istanbul, Turkey. Tel: +90-532-371-72-07; fax: +90-212-560-88-98; E-mail: mdonma@hotmail.com, donmaohm@istanbul.edu.tr Medical Hypotheses (2003) 61(4), 435–438 ª 2003 Elsevier Ltd. All rights reserved. doi:10.1016/S0306-9877(03)00190-7