PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-2 (2)
 

Clipboard (0)
None

Select a Filter Below

Journals
Authors
more »
Year of Publication
Document Types
1.  Size at birth, morning cortisol and cardiometabolic risk markers in healthy Indian children 
Clinical endocrinology  2013;80(1):73-79.
Summary
Objective
Prenatal programming of the hypothalamic-pituitary-adrenal (HPA) axis may link reduced fetal growth with higher adult chronic disease risk. South Asians have a high prevalence of low birth weight and a thin-fat phenotype which is associated with subsequent type 2 diabetes and the metabolic syndrome. Altered HPA activity could be one of the pathological processes underlying this link.
Methods
Plasma morning cortisol and corticosteroid binding globulin (CBG) concentrations were determined in 528 children aged 9.5 years from a prospective birth cohort in India. They had detailed anthropometry at birth, and current measurements of anthropometry, plasma glucose, insulin and lipid concentrations and blood pressure. Insulin resistance (Homeostasis Model Assessment) and insulin secretion (the 30-minute insulin increment) were also assessed.
Results
None of the birth measurements were associated with cortisol concentrations, but both birth weight (P=0.03) and length (P=0.004) were inversely associated with CBG concentrations. Cortisol concentrations were inversely associated with current body mass index (P=0.02), and positively associated with glucose (fasting: P<0.001; 30-minute: P=0.002) concentrations, and systolic blood pressure (P=0.005) but not insulin resistance or the insulin increment.
Conclusion
Higher morning cortisol is associated with higher cardiometabolic risk markers in Indian children. Although cortisol concentrations did not appear to be related to birth size, small size at birth was associated with higher CBG levels, and may be one of the processes by which fetal undernutrition affects adult health. The findings suggest a need for dynamic testing of HPA axis activity (such as measuring stress responses).
doi:10.1111/cen.12143
PMCID: PMC4163626  PMID: 23297873
Cortisol; CBG; birth size; India
2.  PREDICTING ADULT METABOLIC SYNDROME FROM CHILDHOOD BODY MASS INDEX 
Archives of disease in childhood  2008;94(10):768-774.
Objectives
To assess whether serial measurements of childhood body mass index (BMI) give clinically useful predictions of the risk of developing adult metabolic syndrome and impaired glucose tolerance or type 2 diabetes.
Design/setting
Follow-up of a community-based birth cohort in Delhi, India.
Participants
1,492 men and women aged 26-32 years whose BMI was recorded 6-monthly throughout childhood.
Main outcome measures
The predictive value of childhood BMI for adult metabolic syndrome (MS) defined using waist circumference, blood pressure and fasting glucose, triglyceride and HDL-cholesterol concentrations, and impaired glucose tolerance (IGT) and diabetes (DM) diagnosed by oral glucose tolerance tests.
Results
Twenty-five percent of subjects had MS and 15% had IGT/DM. Both outcomes were associated with greater childhood BMI gain (MS: OR 1.63 [95% CI 1.44 to 1.85]; IGT/DM: 1.39 [1.20 to 1.60] per unit increase in within-cohort BMI SD-score between 5-14 years). Best predictions of adult disease were obtained using a combined test comprising i) any increase in BMI SD-score between 5-14 years and ii) a BMI SD-score >0 at 14 years (MS: sensitivity 45%, specificity 78%; IGT/DM: 37%, 73%). Likelihood ratios were low (MS: 1.4-2.0; IGT/DM: 1.2-1.4). A single high BMI measurement at 14 years (overweight or obese, International Obesity Task Force criteria) was highly specific but insensitive (MS: sensitivity 7%, specificity 97%; IGT/DM: 8%, 97%). Charts for plotting BMI SD-scores through childhood were produced.
Conclusions
Serial measurements of childhood BMI give useful predictions of adult risk and could guide advice to children and parents on preventing later disease.
doi:10.1136/adc.2008.140905
PMCID: PMC2749731  PMID: 19015213
Childhood body mass index; type 2 diabetes; metabolic syndrome; predictions

Results 1-2 (2)