Adriëtte Oostvogels

124 Chapter 5 non-overweight population. If the influence of second-degree FHD is already clear at age 5-6 years, FHD could be used as a public health tool to identify young children who are at risk of adverse metabolic outcomes and possibly future disease risk. Methods The present study is part of the Amsterdam Born Children and their Development (ABCD) study (www.abcd-study.nl ) a large prospective multi-ethnic birth cohort. The main goal of the ABCD-study is to examine and determine factors in early life that might explain the later health of the child, and the differences in health between children. The design of this study has been described previously. 25 The present study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human subjects were approved by the review boards of all Amsterdam hospitals and the Registration Committee of Amsterdam. Parents gave their written informed consent for the participation of all children in this study. Informed consent was given for anthropometric measurements and fasting blood collection separately. Study population In 2003-2004, 12373 women in Amsterdam were approached to participate in the ABCD-study at their first visit to the prenatal caregiver. All women were sent a pregnancy questionnaire, which covered socio-demographic characteristics, obstetric history, lifestyles and emotional problems. Of these women, 8266 returned the questionnaire, a response rate of 67%. 7050 women gave permission to follow- up their child after birth. When the child turned 5 years, 6161 mothers were sent a questionnaire, which 4488 (response rate of 73%) returned. A subsample of these children attended the ABCD health check (n=3321) of which 2010 also provided a blood sample. We excluded children whose mother (n=88) and/or father (n=60) had diabetes to exclude confounding by the direct programming effect of diabetes. Children born with congenital anomalies (n=98) were also excluded, as well as children missing valid measurements on outcome variables (n=51). This resulted in a study sample of 3024 singleton children (mean age= 5.7 years) with at least one of the following measurements available: BMI, waist-to-height-ratio (WHtR) fat- percentage, fasting blood glucose, and C-peptide (Figure 1).