Size at birth, morning cortisol and cardiometabolic risk markers in healthy Indian children

Summary Objective Prenatal programming of the hypothalamic‐pituitary‐adrenal (HPA) axis may link reduced foetal growth with higher adult chronic disease risk. South Asians have a high prevalence of low birth weight and a thin‐fat phenotype, which is associated with subsequent type 2 diabetes and the...

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Published in:	Clinical endocrinology (Oxford) Vol. 80; no. 1; pp. 73 - 79
Main Authors:	Krishnaveni, G. V., Veena, S. R., Dhube, A., Karat, S. C., Phillips, D. I. W., Fall, C. H. D.
Format:	Journal Article
Language:	English
Published:	Oxford Blackwell Publishing Ltd 01-01-2014 Blackwell Wiley Subscription Services, Inc
Subjects:	Biological and medical sciences Birth Weight - physiology Cardiovascular Diseases - blood Cardiovascular Diseases - epidemiology Child Endocrinopathies Female Fundamental and applied biological sciences. Psychology Humans Hydrocortisone - blood Hypothalamo-Hypophyseal System - metabolism India Infant, Newborn Male Medical sciences Metabolic diseases Miscellaneous Other metabolic disorders Pituitary-Adrenal System - metabolism Prospective Studies Risk Factors Vertebrates: endocrinology Asia India Endocrinopathy Human Corticosteroid Steroid hormone Antiinflammatory agent Morning Biological marker Metabolic diseases Cardiovascular disease Corporal biometry Cortisol Hydrocortisone Birth Metabolic syndrome Glucocorticoid Coronary heart disease Body size Adrenal hormone Cardiovascular risk Indian Child Endocrinology
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Summary:	Summary Objective Prenatal programming of the hypothalamic‐pituitary‐adrenal (HPA) axis may link reduced foetal growth with higher adult chronic disease risk. South Asians have a high prevalence of low birth weight and a thin‐fat phenotype, which is associated with subsequent type 2 diabetes and the metabolic syndrome. Altered HPA activity could be one of the pathological processes underlying this link. Methods Plasma morning cortisol and corticosteroid‐binding globulin (CBG) concentrations were determined in 528 children aged 9·5 years from a prospective birth cohort in India. They had detailed anthropometry at birth, and current measurements of anthropometry, plasma glucose, insulin and lipid concentrations and blood pressure. Insulin resistance (Homeostasis Model Assessment) and insulin secretion (the 30‐min insulin increment) were also assessed. Results None of the birth measurements were associated with cortisol concentrations, but both birth weight (P = 0·03) and length (P = 0·004) were inversely associated with CBG concentrations. Cortisol concentrations were inversely associated with current body mass index (P = 0·02), and positively associated with glucose (fasting: P < 0·001; 30‐min: P = 0·002) concentrations, and systolic blood pressure (P = 0·005), but not insulin resistance or the insulin increment. Conclusion Higher morning cortisol is associated with higher cardiometabolic risk markers in Indian children. Although cortisol concentrations did not appear to be related to birth size, small size at birth was associated with higher CBG levels, and may be one of the processes by which foetal undernutrition affects adult health. The findings suggest a need for dynamic testing of HPA axis activity (such as measuring stress responses).
Bibliography:	Parthenon Trust, Switzerland ark:/67375/WNG-34PKXK0D-Q Medical Research Council, UK istex:FFE592B59DD48C75AC7472D86826DA4004CB5886 Wellcome Trust, UK ArticleID:CEN12143 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0300-0664 1365-2265
DOI:	10.1111/cen.12143