To the Editor: In their systematic review, Dr Whincup and colleagues1 confirmed the finding in our meta-analysis2 that low birth weight is associated with increased risk of type 2 diabetes. A main difference between these studies, however, relates to the shape of the birth weight–diabetes association. While we found evidence for a U-shaped curve, with both low and high birth weights related to increased risk, Whincup et al concluded that the relation is linear inverse. We question whether their conclusion is appropriate based on methodology and biological plausibility.
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