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

• Published in: Diabetes (New York, N.Y.) Vol. 48; no. 12; pp. 2422 - 2429
• Main Authors: BAVDEKAR, A, YAJNIK, C. S, FALL, C. H. D, BAPAT, S, PANDIT, A. N, DESHPANDE, V, BHAVE, S, KELLINGRAY, S. D, JOGLEKAR, C
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-12-1999
• Subjects: Associated diseases and complications; Biological and medical sciences; Birth Weight; Blood Glucose - metabolism; Blood Pressure; Body Composition; Body Constitution; Body Height; Cardiovascular diseases; Child; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; European Continental Ancestry Group; Female; Follow-Up Studies; Health aspects; Humans; India; Indians; Indians (Asian people); Infant, Low Birth Weight; Infant, Newborn; Insulin - blood; Insulin Resistance; Male; Medical sciences; Parents; Registries; Risk factors; Syndrome; Triglycerides - blood; Asia; India; Human; Target tissue resistance; Pancreatic hormone; Association; Risk factor; Cardiovascular disease; Complication; Birth weight; Child; Epidemiology; Insulin
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diabetes.48.12.2422

Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both?
A Bavdekar ,
C S Yajnik ,
C H Fall ,
S Bapat ,
A N Pandit ,
V Deshpande ,
S Bhave ,
S D Kellingray and
C Joglekar
Department of Pediatrics, King Edward Memorial Hospital, Pune, Maharashtra, India.
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.