The 'thrifty phenotype' hypothesis proposed that fetal undernutrition increases risk of diabetes in later life. Undernourished low birthweight Indian babies are paradoxically more adipose compared to well-nourished European babies, and are at higher risk of diabetes in later life. Twin pregnancies are an example of in utero growth restrictive environment due to shared maternal nutrition. There are few studies of body composition in twins. We performed secondary analysis of anthropometric body composition of twins and singletons in Guinea-Bissau, an economically deprived African country. Anthropometric data were available on 7-34 year-old twins (n = 209, 97 males) and singletons (n = 182, 86 males) in the Guinea-Bissau Twin Registry at the Bandim Health Project. Twins had lower birthweight (2420 vs 3100 g, p < 0.001); and at follow-up, lower height (HAZ mean Z-score difference, -0.21, p = 0.055), weight (WAZ -0.73, p = 0.024) and BMI (BAZ -0.22, p = 0.079) compared to singletons but higher adiposity (skinfolds: +0.33 SD, p = 0.001). Twins also had higher fasting (+0.38 SD, p < 0.001) and 2-hour OGTT glucose concentrations (+0.29 SD, p < 0.05). Linear mixed-effect model accounting for intrapair correlations and interactions confirmed that twins were thinner but fatter across the age range. Data on maternal morbidity and prematurity were not available in this cohort. African populations are known to have a muscular (less adipose) body composition. Demonstration of a thin-fat phenotype in twins in a low socio-economic African country supports the thesis that it could be a manifestation of early life undernutrition and not exclusive to Indians. This phenotype could increase risk of diabetes and related conditions.

TidsskriftJournal of Developmental Origins of Health and Disease
Udgave nummer6
Sider (fra-til)787-793
StatusUdgivet - dec. 2022

Bibliografisk note

Funding Information:
The principal investigator (MBA) received a combined grant from Forsknings-og Innovations Styrelsen, the University of Southern Denmark, and Odense University Hospital. Den Danske Forsknings Fond, Odense University Hospital, Fonden for Lægevidenskabens Fremme and Aase and Ejnar Danielsen’s Foundation supported the data collection. CSY was a visiting professor to the University of Southern Denmark and Danish Diabetes Academy during this work, supported by Novo Nordisk Fonden. The funding sources had no role in the study design, data collection, data analysis or in writing of this manuscript.

Publisher Copyright:
© The Author(s), 2022. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease.


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