Journal
DIABETOLOGIA
Volume 58, Issue 7, Pages 1626-1636Publisher
SPRINGER
DOI: 10.1007/s00125-015-3602-z
Keywords
Cardiovascular risk; Childhood insulin resistance; Diabetes; Indians; Young adults
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Funding
- Wellcome Trust, UK [083460/Z/07/Z]
- Medical Research Council, UK
- Department for International Development, UK
- MRC [MC_UP_A620_1016, MC_UU_12011/3] Funding Source: UKRI
- Medical Research Council [MC_UU_12011/3, U1475000003, MC_UP_A620_1016] Funding Source: researchfish
- Wellcome Trust [083460/Z/07/Z] Funding Source: Wellcome Trust
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Aims/hypothesis The Pune Children's Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood. Methods We followed up 357 participants (75% follow-up) at 21 years of age who had undergone detailed measurements at 8 years of age (glucose, insulin, HOMA-IR and other indices). Oral glucose tolerance, anthropometry, plasma lipids, BP, carotid intima-media thickness (IMT) and arterial pulse wave velocity (PWV) were measured at 21 years. Results Higher fasting glucose, insulin and HOMA-IR at 8 years predicted higher glucose, insulin, HOMA-IR, BP, lipids and IMT at 21 years. A 1 SD change in 8 year variables was associated with a 0.10-0.27 SD change at 21 years independently of obesity/adiposity at 8 years of age. A greater rise in glucose-insulin variables between 8 and 21 years was associated with higher cardiovascular risk factors, including PWV. Participants whose HOMA-IR measurement remained in the highest quartile (n = 31) had a more adverse cardiovascular risk profile compared with those whose HOMA-IR measurement remained in the lowest quartile (n = 28). Conclusions/interpretation Prepubertal glucose-insulin metabolism is associated with adult cardiovascular risk and markers of atherosclerosis. Our results support interventions to improve glucose-insulin metabolism in childhood to reduce cardiovascular risk in later life.
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