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Association between poor glucose tolerance and rapid post natal weight gain in seven-year-old children
N J Crowther1, N Cameron, J Trusler
1Department of Chemical Pathology, South African Institute for Medical Research, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.
Insights
Low birth weight combined with rapid childhood weight gain increases Type II diabetes risk in South African children. This study highlights early life factors impacting glucose tolerance and future diabetes susceptibility.
Area of Science:
- Endocrinology
- Pediatric Health
- Metabolic Syndrome
Background:
- Glucose tolerance declines with lower birth weight.
- Individuals with low birth weight and high adult Body Mass Index (BMI) face increased Type II diabetes risk.
- Limited research exists on these relationships in African populations.
Purpose of the Study:
- To investigate the relationship between glucose tolerance and birth weight in South African children.
- To assess the impact of birth weight and childhood weight gain on glucose metabolism.
- To identify early risk factors for Type II diabetes in this population.
Main Methods:
- Conducted Oral Glucose Tolerance Tests (OGTTs) on 152 seven-year-old black South African children.
- Utilized longitudinal anthropometric data.
- Employed Homeostasis Model Assessment (HOMA) for insulin resistance measurement.
Main Results:
- Found inverse correlations between birth weight and insulin secretion during OGTTs.
- Observed inverse correlations between birth weight and 30-minute glucose concentrations.
- Demonstrated positive correlations between weight velocity, BMI, and insulin resistance (HOMA).
- Children with low birth weight and high 7-year weight showed higher insulin and obesity indices.
Conclusions:
- Low birth weight coupled with rapid childhood weight gain, particularly subcutaneous fat accumulation, impairs glucose tolerance in children.
- These factors increase susceptibility to developing Type II diabetes later in life.
- Highlights the importance of monitoring birth weight and childhood growth for metabolic health in South African children.
Abstract:
A number of studies have shown that glucose tolerance falls with decreasing birth weight and that people with low birth weight and high body mass index (BMI) as adults are those at greatest risk of developing Type II (non-insulin-dependent) diabetes mellitus. No such studies have been carried out in African populations. Therefore we investigated the relation between glucose tolerance and birth weight in a group of 7-year-old black South Africans for whom longitudinal anthropometric data were available. Oral glucose tolerance tests (OGTTs) were carried out on 152 subjects and inverse correlations were found between birth weight and the total amount of insulin secreted during the first 30 min (r = -0.19, p = 0.04) and last 90 min (r = -0.19, p = 0.04) of the oral glucose tolerance test and also between birth weight and the 30 min glucose concentrations (r = -0.20, p = 0.02). Children born with low birth weights but who had high weights at 7 years had higher insulin concentrations and indices of obesity compared with those with low birth weights and low weights at 7 years. There were also positive correlations between weight velocity and BMI (r = 0.24, p = 0.02) and weight velocity and insulin resistance (r = 0.18, p = 0.04) as measured using homeostasis model assessment (HOMA). Thus, low birth weight in conjunction with rapid childhood gains in weight especially as subcutaneous fat, produces poor glucose tolerance in 7-year-old children and can make them susceptible to the development of Type II diabetes later in life.