Objective: To evaluate the continuous metabolic syndrome score (cMetS) in Indian children and to investigate its relationship with the risk of carotid arterial stiffness. Methods: Data on weight, height, mean arterial pressure, serum lipids, insulin, glucose, carotid intima-media thickness and stiffness parameters, that is, pulse wave velocity (PWV), elasticity modulus (Ep), stiffness index (b) and arterial compliance (AC), were assessed in 236 children (6-17 years) from Pune city, India. cMetS was computed using standardized Z-scores for metabolic syndrome (MS) components. cMetS cutoff was obtained by receiver operating characteristic curve analysis across MS components. Results: cMetS was lowest (À3.6 ± 2.0) in normal children and highest (3.3 ± 2.4) in MS children. cMetS increased progressively with number of risk components. The cutoff of cMetS yielding maximal sensitivity (80%) and specificity (94%) for predicting the presence of MS was À0.8 (area under the curve ¼ 0.921 (95% CI: 0.877-0.964)). In children with cMetS above À0.8, average PWV (4.3±0.6 m s À1 ), b (3.8±1.2) and Ep (50.4±14.5 kPa) were significantly higher than the respective values (3.7 ± 0.5 m s À1 ; 3.4 ± 0.8; 37.0 ± 10.0 kPa) in children with cMetS below À0.8, whereas AC was lower (1.2 ± 0.5 mm 2 kPa À1 ) in children with cMetS above À0.8 as against AC (1.4±0.3 mm 2 kPa À1 ) in children with cMetS below À0.8 (Po0.05), demonstrating the risk of stiffness with increasing score. Pearson's correlation coefficients of cMetS with PWV (r ¼ 0.575), b (r ¼ 0.347), AC (r ¼ À0.267) and Ep (r ¼ 0.530) were statistically significant (Po0.01). Conclusion: Results demonstrate the usefulness of cMetS over individual MS components as a better tool for assessment of atherosclerotic risk in children.
We examined the differential associations of each parent's height and BMI with fetal growth, and examined the pattern of the associations through gestation. Data are from 557 term pregnancies in the Pune Maternal Nutrition Study. Size and conditional growth outcomes from 17 to 29 weeks to birth were derived from ultrasound and birth measures of head circumference, abdominal circumference, femur length and placental volume (at 17 weeks only). Parental height was positively associated with fetal head circumference and femur length. The associations with paternal height were detectible earlier in gestation (17–29 weeks) compared to the associations with maternal height. Fetuses of mothers with a higher BMI had a smaller mean head circumference at 17 weeks, but caught up to have larger head circumference at birth. Maternal but not paternal BMI, and paternal but not maternal height, were positively associated with placental volume. The opposing associations of placenta and fetal head growth with maternal BMI at 17 weeks could indicate prioritisation of early placental development, possibly as a strategy to facilitate growth in late gestation. This study has highlighted how the pattern of parental–fetal associations varies over gestation. Further follow-up will determine whether and how these variations in fetal/placental development relate to health in later life.
Fetal size was smaller in a rural Indian population than in European and urban Indian populations, even in mid pregnancy. The deficit varied for different fetal measurements; it was greatest for AC and BPD and least for FL and HC.
Aims/hypothesisThe Pune Children’s Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood.MethodsWe 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.ResultsHigher 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/interpretationPrepubertal 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.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-015-3602-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
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