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[Ponderal index at birth predicts metabolic syndrome in mid-aged Chinese]
Jie Mi1, Hong Cheng, Xiao-Yuan Zhao
1Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.
Insights
Thin babies are at higher risk for metabolic syndrome later in life. Overweight adults who were thin at birth face the greatest risk, highlighting the importance of birth size and adult weight for metabolic health.
Area of Science:
- Developmental Origins of Health and Disease (DOHaD)
- Metabolic Health
- Epidemiology
Background:
- The Ponderal Index (PI) at birth reflects fetal growth and may influence long-term metabolic health.
- Metabolic syndrome (MS) is a cluster of conditions increasing cardiovascular disease and diabetes risk.
Purpose of the Study:
- To investigate the association between birth Ponderal Index (PI) and the development of metabolic syndrome (MS) in middle age.
- To explore the interaction between birth PI and adult Body Mass Index (BMI) on MS risk.
Main Methods:
- A cohort of 975 adults (aged 41-52) underwent clinical examinations, including anthropometry and metabolic markers.
- Metabolic syndrome was diagnosed using the 1999 WHO definition.
- Multivariate logistic regression analyzed the effects of birth PI and adult BMI on MS, including interaction effects.
Main Results:
- MS prevalence was 18.7%; a decreasing trend in MS risk was observed with increasing birth PI percentiles.
- Both lower birth PI (beta=-0.125, P=0.002) and higher adult BMI (beta=0.430, P=0.000) were significant predictors of MS.
- A synergistic interaction was found: thin at birth (PI < 25th percentile) and overweight in adulthood (BMI ≥ 24 kg/m2) had a significantly higher MS risk (OR=29.1).
Conclusions:
- Low birth Ponderal Index (thin at birth) is an independent predictor of metabolic syndrome in middle age.
- Birth size modifies the impact of adult BMI on metabolic syndrome risk.
- Overweight in adulthood is particularly detrimental for individuals with evidence of fetal growth restriction (low birth PI).
Objective:
To examine the association between Ponderal index (PI) at birth and metabolic syndrome during middle age.
Methods:
Totally, 975 adults (494 men and 481 women) aged 41-52 from the study cohort of Fetal Origin of Adult Disease were recruited in the study for clinic examinations, involving anthropometry and measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum lipid profile. Their HOMA-insulin resistance (IR) index was estimated. Metabolic syndrome (MS) was diagnosed according to 1999 WHO definition. Multivariate logistic regression analysis was used to estimate the effect of PI on MS and the interaction between PI at birth and body mass index (BMI) in adulthood.
Results:
Prevalence of MS was 18.7% in this mid-aged population, 24.8%, 19.4%, 16.3% and 14.0% in those with less than the 25th percentile, the 25th to less than the 50th percentile, the 50th to less than the 75th percentile and more than 75th percentile of PI at birth, respectively, in a decreasing trend (chi2 M-H for trend=9.938 adjusted for gender, P=0.002). Logistic regression analysis showed that both PI at birth and BMI during adulthood could influence their occurrence of MS (beta=-0.125, P=0.002, for PI; and beta=0.430, P=0.000, for BMI). A synergistic effect between PI at birth and BMI in adulthood was observed in this population. Persons who were thin at birth with PI less than the 25th percentile, and became overweight with BMI greater than or equal to 24 kg/m2 later in their life, were at higher risk of suffering from metabolic syndrome (OR=29.1, 95% CI=13.6-62.1), in comparison with those who became overweight during adulthood from a higher PI at birth (OR=16.0, 95% CI=7.9-32.3) and those who were thin at birth and remained a appropriate BMI during their adulthood (OR=2.0, 95% CI=0.7-5.7). Attributable fraction of the interaction to MS was 34.6%.
Conclusions:
Thin at birth was a predictor for later occurrence of metabolic syndrome, as well as an effect modifier for the association between of later BMI and metabolic syndrome, i.e., overweight later in his life was most deleterious for a person with growth retardation at birth.
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