The long-term consequences of intra-uterine growth retardation (IUGR) on po
stnatal growth and development are well known, More recently, several epide
miological and clinical studies in adults have provided evidence that low b
irth weight is an independent risk factor for the syndrome of insulin resis
tance in mid to late adulthood. In the present study, we demonstrated that
individuals born small for gestational age showed isolated insulin resistan
ce in early adulthood with no impairment of serum lipid concentrations and
blood pressure at this age. Angiotensin-I converting enzyme gene polymorphi
sm has also been shown to modulate the effect on insulin resistance of bein
g small for gestational age. Fetal malnutrition may be the critical factor
to explain the relationship between IUGR and insulin resistance which might
be modulated by genetic factors.