Low birth weight and early weight gain in the metabolic syndrome: Consequences for infant nutrition

ObjectiveLow birth weight (LBW) is common in the Indian population and may represent an important predisposing factor for type 2 diabetes (T2D) and the metabolic syndrome. Intensive metabolic examinations in ethnic LBW Asian Indians have been almost exclusively performed in immigrants living outside India. Therefore, we aimed to study the metabolic impact of being born with LBW in a rural non-migrant Indian population.Subjects and methodsOne hundred and seventeen non-migrant, young healthy men were recruited from a birth cohort in a rural part of south India. The subjects comprised 61 LBW and 56 normal birth weight (NBW) men, with NBW men acting as controls. Subjects underwent a hyperinsulinaemic euglycaemic clamp, i.v. and oral glucose tolerance tests and a dual-energy X-ray absorptiometry scan. The parents' anthropometric status and metabolic parameters were assessed.ResultsMen with LBW were shorter (167±6.4 vs 172±6.0 cm,P<0.0001), lighter (51.9±9 vs 55.4±7 kg,P=0.02) and had a reduced lean body mass (42.1±5.4 vs 45.0±4.5 kg,P=0.002) compared with NBW controls. After adjustment for height and weight, the LBW subjects had increased diastolic blood pressure (77±6 vs 75±6 mmHg,P=0.01). Five LBW subjects had impaired glucose tolerance.In vivoinsulin secretion and peripheral insulin action were similar in both the groups. Mothers of the LBW subjects were 3 cm shorter than the control mothers.ConclusionOnly subtle features of the metabolic syndrome and changes in body composition among LBW rural Indians were found. Whether other factors such as urbanisation and ageing may unmask more severe metabolic abnormalities may require a long-term follow-up.

Download Full-text

Components of the Metabolic Syndrome in Early Childhood in Very-Low-Birth-Weight Infants

Hormone Research in Paediatrics ◽

10.1159/000355597 ◽

2014 ◽

Vol 81 (1) ◽

pp. 43-49 ◽

Cited By ~ 14

Author(s):

Miranda de Jong ◽

Harrie N. Lafeber ◽

Anneke Cranendonk ◽

Mirjam M. van Weissenbruch

Keyword(s):

Metabolic Syndrome ◽

Early Childhood ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

The Metabolic Syndrome

Download Full-text

Early Origins of the Metabolic Syndrome: Role of Small Size at Birth, Early Postnatal Weight Gain, and Adult IGF-I

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-1426 ◽

2012 ◽

Vol 97 (8) ◽

pp. 2637-2643 ◽

Cited By ~ 33

Author(s):

Gerthe F. Kerkhof ◽

Ralph W. J. Leunissen ◽

Anita C. S. Hokken-Koelega

Keyword(s):

Metabolic Syndrome ◽

Weight Gain ◽

Birth Weight ◽

Insulin Sensitivity ◽

Low Birth Weight ◽

Density Lipoprotein ◽

Regression Analyses ◽

C Reactive Protein ◽

Reactive Protein ◽

Igf I

Abstract Background: The relationship between low birth weight and increased risk for metabolic syndrome (MetS) in later life has been frequently described, but mechanisms underlying this association remain unknown. Methods: In 280 young adults of the PROGRAM study, aged 18–24 yr, we investigated associations of birth weight, gain in weight for length during early life, and adult IGF-I sd score (SDS), with number of MetS components (ordinal regression analyses), prevalence of MetS components and MetS (logistic regression analyses), and other metabolic parameters (linear regression analyses). Revised criteria of the National Cholesterol Educational Program (Adult Treatment Panel III) were used to determine components of MetS. The other metabolic parameters were C-reactive protein, insulin sensitivity, trunk fat mass, total cholesterol, and low-density lipoprotein cholesterol. Results: More gain in weight for length SDS in the first 3 months of life was significantly associated with an increased number of MetS components [odds ratio (OR) = 1.34], prevalence of low high-density lipoprotein cholesterol (OR = 1.49), prevalence of MetS (OR = 2.51), increased C-reactive protein levels, and lower insulin sensitivity (P = 0.007) at the age of 21 yr. Low birth weight SDS was associated with lower insulin sensitivity (P = 0.036), but low birth weight SDS and adult IGF-I SDS were not significantly associated with any of the MetS components or MetS prevalence at 21 yr. Conclusion: Our study demonstrates that higher gain in weight for length in the first 3 months of life is associated with a higher prevalence of MetS at 21 yr, whereas low birth weight and low adult IGF-I are not.

Download Full-text

Decreased insulin sensitivity in small for gestational age males treated with GH and preterm untreated males: a study in young adults.

Acta Endocrinologica ◽

10.1530/eje-08-0152 ◽

2008 ◽

Vol 158 (6) ◽

pp. 899-904 ◽

Cited By ~ 5

Author(s):

J Rotteveel ◽

M M van Weissenbruch ◽

H A Delemarre-Van de Waal

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Birth Weight ◽

Insulin Sensitivity ◽

Low Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Gh Therapy ◽

The Metabolic Syndrome ◽

Preterm Born

BackgroundLow birth weight and preterm birth are associated with growth delay as well as the development of insulin resistance. Insulin resistance is especially seen in subjects with catch-up growth. GH therapy induces growth in short subjects with low birth weight at term, but little is known about the long-term effects on insulin sensitivity. GH therapy is now also proposed for preterms that remain short.MethodsWe investigated insulin sensitivity using the gold standard hyperinsulinemic-euglycemic clamp technique in 10 young adult males born small for gestational age (SGA) who had been treated with GH during childhood (GH) in comparison with 15 males born preterm AGA (premAGA), 13 males born preterm SGA (premSGA), and 15 males born at term with normal birth weight (CON). Furthermore, we investigated the presence of the metabolic syndrome.ResultsInsulin sensitivity was decreased in premAGA, premSGA, and GH subjects compared with CON males. The metabolic syndrome was not present in any of the groups.ConclusionInsulin sensitivity is decreased in GH-treated SGA born males as well as in preterm born males. With respect to the SGA subjects, whether the difference results from perinatal-, postnatal-, or GH therapy-related factors are not known. With respect to the preterm born subjects, close surveillance is needed when commencing GH therapy.

Download Full-text