Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both?

Abstract

We have studied 477 8-year-old Indian children to define the relationship between birth weight and cardiovascular risk factors, including insulin resistance syndrome (IRS) variables and plasma total and LDL cholesterol concentrations. All risk factors were strongly related to current weight. After adjustment for current weight, age, and sex, lower birth weight was associated with higher systolic blood pressure (P = 0.008), fasting plasma insulin and 32-33 split proinsulin concentrations (P = 0.08 and 0.02), glucose and insulin concentrations 30 min postglucose (P = 0.06 and 0.04), subscapular/triceps skinfold ratio (P = 0.003), and plasma total and LDL cholesterol concentrations (P = 0.002 and 0.001). Lower birth weight was associated with increased calculated insulin resistance (homeostasis model assessment [HOMA], P = 0.03), but was not related to the HOMA index of beta-cell function. The highest levels of IRS variables and total and LDL cholesterol were in children of low birth weight but high fat mass at 8 years. Taller height at 8 years predicted higher fasting plasma insulin concentrations, insulin resistance, and plasma total and LDL cholesterol concentrations. The most insulin-resistant children were those who had short parents but had themselves grown tall. Although the implications of our findings in relation to height are unclear, interventions to improve fetal growth and to control obesity in childhood are likely to be important factors in the prevention of cardiovascular disease and IRS in India.

Birth weight, current body mass index, and insulin sensitivity and secretion in young adults in two Latin American populations

“…Evidence that BW affects HOMA%b is inconclusive [12]. There are reports that low BW was associated with elevated HOMA%b [5], whereas others did not found an association [1,2,26]. In our study BW z-score was associated with HOMA%b before and after adjustment for current BMI z-score, but only in Ribeirao Preto.…”

“…There has been some controversy too as to whether the association between birth weight and insulin resistance is linear [1,2], as it was the case in a Pima Indian population [14].…”

“…However, it would be important to establish whether the association has already been established in childhood [2,6,16] or young adulthood as some have suggested [4,5]. Studies performed in children and young adults have used Homeostasis Model Assessment (HOMA) to estimate insulin resistance because diabetes prevalence is low at these ages [17].…”

Systematic review indicates postnatal growth in term infants born small‐for‐gestational‐age being associated with later neurocognitive and metabolic outcomes

“…In four observational studies comprising 3180 children, including an observational study among breastfed children 21, faster postnatal growth measured as the weight gain between birth and two to eight years was positively associated with a higher risk of high BP at the ages of seven to 15 years 21, 44, 48, 49. In contrast, one further study comprising 106 children reported no association between weight gain at birth to 21 years with BP at the age of 21 years.…”

Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life

“…Babies that are small and thin at birth lack muscle, a deficiency which will persist as the critical period for muscle growth occurs in utero and there is little cell replication after birth [17]. If they develop a high body mass during childhood they can have a disproportionately high fat mass in relation to lean body mass, which will lead to insulin resistance [12,18,19].…”