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The question posed is to what extent is the
relationship between intrauterine growth restriction and insulin resistance attributed to
nutritional programming of the fetus and to what extent is it attributed to SES and
related factors that influence both infant growth and adulthood disease? Most study
populations have not had available data on socioeconomic factors at birth and in
adulthood. Studies with SES data have found that the inverse trend is not substantially
altered by adjustments for these factors. The Harvard Nurses Study had occupation data on
parents when the nurses were 16 years of age. The Rancho Bernardo study, discussed
earlier, is a homogeneous SES population as is the Male Health Professionals Study. In a
study of men in South Wales investigators had information on father's social class, men's
own social class, marital status as well as other established risk factors for coronary
heart disease (Frankel S, et al. Lancet 1996;348:1478-80). |