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Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both?
A Bavdekar1, C S Yajnik, C H Fall
1Department of Pediatrics, King Edward Memorial Hospital, Pune, Maharashtra, India.
Insights
Lower birth weight in Indian children is linked to higher cardiovascular disease risk factors, including insulin resistance and high cholesterol. Improving fetal growth and managing childhood obesity are key for prevention.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Cardiovascular risk factors and insulin resistance syndrome (IRS) are emerging concerns in pediatric populations.
- The influence of birth weight on long-term metabolic and cardiovascular health in Indian children requires further investigation.
Purpose of the Study:
- To examine the association between birth weight and cardiovascular risk factors, including IRS variables and lipid profiles, in 8-year-old Indian children.
- To explore the impact of current weight, height, and body composition on these relationships.
Main Methods:
- Cross-sectional study of 477 Indian children aged 8 years.
- Assessment of cardiovascular risk factors: systolic blood pressure, fasting and post-glucose insulin and glucose levels, plasma total and LDL cholesterol.
- Calculation of insulin resistance using homeostasis model assessment (HOMA).
- Measurement of body fat distribution (subscapular/triceps skinfold ratio) and height.
Main Results:
- Lower birth weight was significantly associated with higher systolic blood pressure, insulin resistance (HOMA), fasting insulin, and total and LDL cholesterol levels, even after adjusting for current weight, age, and sex.
- Children with low birth weight and high body fat mass at age 8 exhibited the highest IRS variables and cholesterol levels.
- Taller height at age 8 predicted higher insulin resistance and lipid levels, with the most insulin-resistant children being those who were tall despite having short parents.
Conclusions:
- Birth weight is a significant determinant of cardiovascular risk factors and insulin resistance in Indian children.
- Childhood obesity and body composition interact with birth weight to influence metabolic health.
- Interventions targeting improved fetal growth and childhood obesity management are crucial for preventing cardiovascular disease and IRS in this population.
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.
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