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Adiposity, insulin resistance and cardiovascular risk factors in 9–10-year-old Indian children: relationships with birth size and postnatal growth

Published online by Cambridge University Press:  01 October 2010

G. V. Krishnaveni ,
S. R. Veena ,
A. K. Wills ,
J. C. Hill ,
S. C. Karat  and
C. H. D. Fall
G. V. Krishnaveni*
Affiliation:
Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mandi Mohalla, Mysore, India
S. R. Veena
Affiliation:
Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mandi Mohalla, Mysore, India
A. K. Wills
Affiliation:
MRC Epidemiology Resource Centre, Southampton General Hospital, Southampton, UK
J. C. Hill
Affiliation:
MRC Epidemiology Resource Centre, Southampton General Hospital, Southampton, UK
S. C. Karat
Affiliation:
Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mandi Mohalla, Mysore, India
C. H. D. Fall
Affiliation:
MRC Epidemiology Resource Centre, Southampton General Hospital, Southampton, UK
*
*Address for correspondence: Dr G. V. Krishnaveni, PO Box 38, Holdsworth Memorial Hospital, Mandi Mohalla, Mysore 570021, South India. (Email gv.krishnaveni@gmail.com)
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Abstract

Lower birthweight, and rapid childhood weight gain predict elevated cardiovascular risk factors in children. We examined associations between serial, detailed, anthropometric measurements from birth to 9.5 years of age and cardiovascular risk markers in Indian children. Children (n = 663) born at the Holdsworth Memorial Hospital, Mysore, India were measured at birth and 6–12 monthly thereafter. At 9.5 years, 539 (255 boys) underwent a 2-h oral glucose tolerance test, and blood pressure (BP) and fasting lipid concentrations were measured. Insulin resistance was calculated using the HOMA equation. These outcomes were examined in relation to birth measurements and changes in measurements (growth) during infancy (0–2 years), 2–5 years and 5–9.5 years using conditional s.d. scores. Larger current weight, height and skinfold thickness were associated with higher risk markers at 9.5 years (P < 0.05). Lower weight, smaller length and mid-arm circumference at birth were associated with higher fasting glucose concentrations at 9.5 years (P ⩽ 0.01). After adjusting for current weight/height, there were inverse associations between birthweight and/or length and insulin concentrations, HOMA, systolic and diastolic BP and plasma triglycerides (P < 0.05). Increases in conditional weight and height between 0–2, 2–5 and 5–9.5 years were associated with higher insulin concentrations, HOMA and systolic BP. In conclusion, in 9–10-year-old Indian children, as in other studies, cardiovascular risk factors were highest in children who were light or short at birth but heavy or tall at 9 years. Greater infant and childhood weight and height gain were associated with higher risk markers.

Keywords

birthweightinfancyinsulin resistancepostnatal growth
Type
Original Articles
Information
Journal of Developmental Origins of Health and Disease , Volume 1 , Issue 6 , December 2010 , pp. 403 - 411
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2010

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References

1. Barker, DJP. Mothers, Babies and Health in Later Life, 2nd edn, 1998. Churchill Livingstone: London.Google Scholar
2. Whincup, PH, Kaye, SJ, Owen, CG, et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008; 300, 2886–2897.Google ScholarPubMed
3. Huxley, R, Owen, CG, Whincup, PH, et al. Is birthweight a risk factor for ischemic heart disease in later life? Am J Clin Nutr. 2007; 85, 1244–1250.CrossRefGoogle ScholarPubMed
4. Bhargava, SK, Sachdev, HPS, Fall, CHD, et al. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med. 2004; 350, 865–875.CrossRefGoogle ScholarPubMed
5. Bavdekar, A, Yajnik, CS, Fall, CH, et al. Insulin resistance syndrome in 8-year-old Indian children. Small at birth, big at 8 years, or both? Diabetes. 1999; 48, 2422–2429.CrossRefGoogle Scholar
6. Lawlor, DA, Riddoch, CJ, Page, AS, et al. The association of birthweight and contemporary size with insulin resistance among children from Estonia and Denmark: findings from the European Youth Heart Study. Diabet Med. 2005; 22, 921–930.CrossRefGoogle ScholarPubMed
7. Joglekar, CV, Fall, CH, Deshpande, VU, et al. Newborn size, infant and childhood growth, and body composition and cardiovascular disease risk factors at the age of 6 years: the Pune Maternal Nutrition Study. Int J Obes (Lond). 2007; 31, 1534–1544.CrossRefGoogle ScholarPubMed
8. Fall, CH, Yajnik, CS, Rao, S, et al. Micronutrients and fetal growth. J Nutr. 2003; 133(Suppl. 2), 1747S–1756S.CrossRefGoogle ScholarPubMed
9. Yajnik, CS, Fall, CHD, Coyaji, KJ, et al. Neonatal anthropometry: the thin-fat Indian baby; the Pune Maternal Nutrition Study. Int J Obes. 2002; 27, 173–180.CrossRefGoogle Scholar
10. Krishnaveni, GV, Hill, JC, Veena, SR, et al. Truncal adiposity is present at birth and in early childhood in south Indian children. Indian Pediatr. 2005; 42, 527–538.Google ScholarPubMed
11. Yajnik, CS. Early life origins of insulin resistance and type 2 diabetes in India and other Asian countries. J Nutr. 2004; 134, 205–210.CrossRefGoogle ScholarPubMed
12. Krishnaveni, GV, Hill, JC, Leary, SD, et al. Anthropometry, glucose tolerance and insulin concentrations in Indian children: relationships to maternal glucose and insulin concentrations during pregnancy. Diabetes care. 2005; 28, 2919–2925.CrossRefGoogle ScholarPubMed
13. Carpenter, MW, Coustan, DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982; 159, 768–773.CrossRefGoogle Scholar
14. International Institute for Population Sciences (IIPS) and Operations Research Centre (ORC) Macro. National Family Health Survey (NFHS-2), India 1998–1999, 2001. IIPS, Maharashtra, Mumbai.Google Scholar
15. Matthews, DR, Hosker, JP, Rudenski, AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting glucose and insulin concentrations in man. Diabetologia. 1985; 28, 412–419.CrossRefGoogle ScholarPubMed
16. Lucas, A, Fewtrell, MS, Cole, TJ. Fetal origins of adult disease- the hypothesis revisited. BMJ. 1999; 319, 245–249.CrossRefGoogle ScholarPubMed
17. Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000; 320, 1–6.CrossRefGoogle ScholarPubMed
18. World Health Organization: Child growth standards. Accessed 13 February 2009 from http://www.who.int/childgrowth/en/ Google Scholar
19. Kelishadi, R. Childhood overweight, obesity and the metabolic syndrome in the developing countries. Epidemiol Rev. 2007; 29, 62–76.CrossRefGoogle ScholarPubMed
20. Huxley, R, Neils, A, Collins, R. Unravelling the fetal origins hypothesis: is there really an inverse association between birthweight and subsequent blood pressure? Lancet. 2002; 360, 659–665.CrossRefGoogle ScholarPubMed
21. Tu, Y, West, R, Ellison, GTH, Gilthorpe, MS. Why evidence for the fetal origins of adult disease might be a statistical artefact: the ‘reversal paradox’ for the relation between birth weight and blood pressure in later life. Am J Epidemiol. 2005; 161, 27–32.CrossRefGoogle Scholar
22. Hales, CN, Barker, DJP. Type 2 (non-insulin-dpendant) diabetes mellitus : the thrifty phenotype hypothesis. Diabetologia. 1992; 35, 595–601.CrossRefGoogle ScholarPubMed
23. Barker, DJ, Fall, CH. Fetal and infant origins of cardiovascular disease. Arch Dis Child. 1993; 68, 797–799.CrossRefGoogle ScholarPubMed
24. Singhal, A, Lucas, A. Early origins of cardiovascular disease: is there a unifying hypothesis? Lancet. 2004; 363, 1642–1644.CrossRefGoogle Scholar
25. Ekelund, U, Ong, KK, Linné, Y, et al. Association of weight gain in infancy and early childhood with metabolic risk in young adults. J Clin Endocrinol Metab. 2007; 92, 98–103.CrossRefGoogle ScholarPubMed
26. Fall, CH, Sachdev, HS, Osmond, C, et al. New Delhi Birth Cohort. Adult metabolic syndrome and impaired glucose tolerance are associated with different patterns of BMI gain during infancy: data from the New Delhi Birth Cohort. Diabetes Care. 2008; 31, 2349–2356.CrossRefGoogle Scholar
27. Uauy, R, Kain, J, Mericq, V, Rojas, J, Corvalán, C. Nutrition, child growth, and chronic disease prevention. Ann Med. 2008; 40, 11–20.CrossRefGoogle ScholarPubMed
28. Adair, LS, Martorell, R, Stein, AD, et al. Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter? Am J Clin Nutr. 2009; 89, 1383–1392.CrossRefGoogle ScholarPubMed