Adolescents with Mild Stunting Show Alterations in Glucose and Insulin Metabolism

Santos, Carla Danusa da Luz; Clemente, Ana Paula Grotti; Martins, Vinícius Gomes; Albuquerque, Maria Paula de; Sawaya, Ana Lydia

doi:10.1155/2010/943070

Cited by 19 publications

(15 citation statements)

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“…Because it reflects the accumulated, permanent, and long-term effects of deficiency in early childhood nutrition, stunting is widely considered the best epidemiological indicator for assessing chronic malnutrition [41]. Early life stunting has been shown to be associated with increased insulin resistance [42], altered fat metabolism [43], increased risk for chronic disease [44], impaired immune function [45], and increased risk of hypertension and cardiovascular disease [46]. Compounding these later life morbidities is the strong body of evidence consistently demonstrating the association between stunting and cognitive deficits [18, 20, 47].…”

Section: Discussionmentioning

confidence: 99%

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

et al. 2016

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BackgroundLead toxicity is of particular public health concern given its near ubiquitous distribution in nature and established neurotoxicant properties. Similar in its ubiquity and ability to inhibit neurodevelopment, early childhood stunting affects an estimated 34 % of children under 5 in low- and middle-income countries. Both lead and stunting have been shown to be associated with decreased neurodevelopment, although the relationship between these childhood burdens is underexplored. The association between lead exposure and stunting has been previously established, yet limited data are available on susceptibility windows.MethodsWhole blood lead samples were collected from rural Bangladeshi children at delivery (umbilical cord blood) and at age 20–40 months (fingerstick blood). Stunting was determined using the Child Growth Standards developed from the World Health Organization Multicentre Growth Reference Study. Children with height for age < -2 z-scores below the median of the WHO Child Growth Standards were classified as stunted in all analyses.ResultsMedian (IQR) umbilical cord and fingerstick blood lead levels were 3.1 (1.6–6.3) μg/dl and 4.2 (1.7–7.6) μg/dl, respectively. In adjusted multivariable regression models, the odds of stunting at 20–40 months increased by 1.12 per μg/dl increase in blood lead level (OR = 1.12, 95 % CI: 1.02–1.22). No association was found between cord blood lead level and risk of stunting (OR = 0.97, 95 % CI: 0.94–1.00).ConclusionsThere is a significant association between stunting and concurrent lead exposure at age 20–40 months. This association is slightly attenuated after controlling for study clinic site. Additional research including more precise timing of lead exposure during these critical 20–40 months is needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0190-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

et al. 2016

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“…Another study reported that postnatal undernutrition during the first year of life was associated with higher 2-hour glucose and insulin levels after an oral glucose tolerance test (Gonzalez-Barranco et al, 2003). A study in adolescents from Brazil found that short height or stunting was associated with higher fasting glucose, insulin resistance, and abdominal obesity (da Luz Santos et al, 2010). Collectively, these findings lend indirect support to the hypothesis that poor net nutrition during postnatal growth and development, manifested in short legs in our study, alters regulation of physiologic mechanisms responsible for energy balance, resulting in excess adiposity and increased risk of adult diabetes.…”

Section: Discussionmentioning

confidence: 99%

Relative leg length is associated with type 2 diabetes differently according to pubertal timing: The Brazilian longitudinal study of adult health

Mueller

Duncan

Barreto

et al. 2014

American J Hum Biol

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Objectives Studies from developed societies have shown that individuals with short legs relative to height have higher risk of type 2 diabetes. This has been much less explored in less developed populations where influences on relative leg length and diabetes may differ. The Brazilian Longitudinal Study of Adult Health (in Portuguese, ELSA-Brasil) allows us to test, in a cohort born (1934–1975) and raised when undernutrition was common, whether short legs relative to height is positively associated with diabetes, independent of early-life factors, including birth weight, age at menarche, and young-adult BMI. Methods We used baseline, cross-sectional data from 15,105 participants aged 35–74 years participating in ELSA-Brasil. We created age-and-sex-specific Z scores for leg length index (leg length/height x 100) according to an external reference. Diabetes was defined by self-reported physician diagnosis, medication use, fasting and 2-hour post-75g-load glucose, and A1C. Results A one-unit decrement in leg-length-index Z score was associated with 12% (8–17%) higher prevalence of diabetes in Brazilian adults, after adjustment through Poisson regression for confounders, including race, maternal education, and birth weight. This association persisted after further adjustment for menarche age, BMI (at age 20), buttocks circumference, and waist circumference. It was stronger among women with early menarche (p interaction=0.02). Leg length index was also positively associated with fasting glucose, fasting insulin, 2-hour glucose, and A1C (p<0.05). Conclusions In contemporary Brazilian adults, short legs relative to height is positively associated with diabetes independent of measures of intrauterine growth, pubertal timing, young-adult adiposity. This association is stronger in women with early menarche.

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“…Much of the evidence to support the relationship between stunting and obesity emerges from some cross-sectional studies that point towards a possible risk of overweight/ obesity among stunted children (7)(8)(9)(10)(11) and adolescents (12)(13)(14) . Some studies have also shown that stunted children and adolescents have higher total body fat percentage (BF%) and central adiposity (14)(15)(16)(17)(18) .…”

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confidence: 99%

“…Some studies have also shown that stunted children and adolescents have higher total body fat percentage (BF%) and central adiposity (14)(15)(16)(17)(18) . Central adiposity has been independently associated with high levels of serum TAG, non-HDL cholesterol, fasting insulin, homeostatic model assessment of insulin resistance and C-reactive protein in young children (19,20) .…”

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confidence: 99%

BMI, body fat and waist-to-height ratio of stunted v. non-stunted Indian children: a case–control study

Savanur¹,

Ghugre²

2016

Public Health Nutr.

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Objective: To compare the BMI, body fat and waist-to-height ratio (WHtR) of stunted and non-stunted children following different growth trajectories from low socio-economic strata in Mumbai, India. Design: Cross-sectional, case-control study. Weight, height, skinfold thicknesses and waist circumference were measured. Information regarding the duration of breast-feeding, age at initiation of complementary feeding and income was obtained. Birth weight was obtained from records. BMI, body fat, WHtR and change in weight SD were calculated. Setting: Children who were beneficiaries of anganwadis, Mumbai city, India. Subjects: Three hundred and thirty children aged 2-4 years were selected in each of the stunted and non-stunted groups after matching for age and sex. Results: After adjusting for birth weight, change in weight SD, duration of breastfeeding, age at complementary feeding initiation and income, stunted children had significantly higher body fat, WHtR and BMI than the non-stunted (P < 0·01). The stunted and non-stunted children were classified based on their change in weight SD. Stunted children with no change in weight SD had higher mean body fat, BMI (P < 0·01) and WHtR (P < 0·05) than their non-stunted counterparts. In the catch-up growth group, stunted children had higher BMI and WHtR than the non-stunted (both P < 0·001). In the catch-down growth group, stunted children had higher BMI than the non-stunted (P < 0·001). Conclusions: Stunting was seen to increase the tendency of conserving body fat in young children. Such a tendency, if continued during later childhood and adolescence, can increase the risk of obesity and non-communicable diseases. KeywordsStunting Body fat BMI Waist-to-height ratio Children IndiaGlobally, 171 million children (27 %) below 5 years of age were stunted in 2010 (1) . The problem of stunting or chronic undernutrition is deeply rooted in poverty and deprivation, affecting mainly the developing and underdeveloped nations. Over the previous two decades, the prevalence of stunting in Asia has reduced by half from 48·6 % to 27·6 % in the years 1990 to 2010 (1) . In comparison with the global rates, the prevalence of stunting in India is much higher (i.e. 48 %) with the rate in rural areas (50·7 %) exceeding that in urban ones (39·6 %) (2)

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Adolescents with Mild Stunting Show Alterations in Glucose and Insulin Metabolism

Cited by 19 publications

References 30 publications

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

Relative leg length is associated with type 2 diabetes differently according to pubertal timing: The Brazilian longitudinal study of adult health

BMI, body fat and waist-to-height ratio of stunted v. non-stunted Indian children: a case–control study

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