Undernutrition and suboptimal growth during the first year are associated with glycemia but not with insulin resistance in adulthood

Abstract

This study aimed to assess whether weight, length, and conditional growth during the first year are associated with glycemia and insulin resistance among young adults. A non-concurrent longitudinal design was used in the study. This is a population-based cohort study, composed of people aged from 22 to 28 years. We estimated z-scores from birth to the first year and the infants were classified as stunted, underweight, overweight, obese, wasted, and at risk of wasting, using cut-offs proposed by the World Health Organization (Child Growth Standards, 2006). Conditional weight and length gain variables were estimated. Glycemia, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and single point insulin sensitivity estimator (SPISE) were evaluated in adulthood. Multiple linear regressions that includes the variables associated with glycemia and insulin resistance were used. In total, 1,070 subjects were evaluated and glycemia in adulthood was higher among subjects who were wasted or at risk of wasting at 12 months (β coefficient = 2.77; 95%CI: 0.37; 5.21). In relation to normal weight, those subjects who were overweight at 12 months showed the lowest glycemia (β coefficient = -2.39; 95%CI: -4.32; -0.36). Conditional weight gain in the first year was negatively associated with glycemia in adulthood (β coefficient = -0.65; 95%CI: -1.23; -0.08). SPISE was higher among underweight subjects, and negatively associated with conditional relative weight gain and conditional linear growth in the first year. In conclusion, we found that undernutrition and suboptimal growth were associated with higher glycemia.

Association of postnatal severe acute malnutrition with pancreatic exocrine and endocrine function in children and adults: a systematic review

“…There were thirty-two cross-sectional studies, (18,22,24,27,29,32,(34)(35)(36)39,42,43,48,51,53,54,57,58,60,(66)(67)(68)71,72,(75)(76)(77)(78)(79)(81)(82)(83) , twenty-seven cohort studies, (17,(19)(20)(21)28,30,31,33,37,41,46,47,49,50,52,55,56,59,61,(63)(64)…”

“…Individual studies' quality scores are shown in Supplementary Data 3. Twelve studies had an overall quality rating considered to be high (16,59,(67)(68)(69)(72)(73)(74)(75)(76)78) , fifteen studies were rated as medium (39,44,45,55,58,62,65,66,70,71,77,79,80,82,83) , seventeen studies were rated as low (17,18,(23)(24)(25)27,29,30,35,40,43,46,52,53,57,60,81) and the remaining twenty-four as very low (19)(20)(21)(22)26,28,(31)(32)…”

“…Researchers rarely used these tolerance tests to diagnose diabetes but were interested in various glucose metabolism indicators calculated from the glucose and insulin levels during the tests, including AUC, insulin : glucose ratios and glucose disappearance rate. Homeostatic model assessment indices were rarely calculated (46,75) . Several studies investigated glucose metabolism after injection or perfusion with glucagon (43,47,56) , insulin (46,55) or arginine (51,54,55) .…”

“…This group comprises the bulk of the included papers but only one was scored as medium quality (39) and the rest were rated as low or very low quality. Fasting blood or plasma glucose (not always distinguished in the papers and referred to here as FBG), was generally unaffected by acute malnutrition (33)(34)(35)37,38,47) but decreased FBG was also reported (29,36,46) . HbA1c was higher in children with kwashiorkor or marasmus compared with controls and FBG and HbA1c were inversely associated (29) .…”

“…Homeostatic model assessment indices were rarely calculated (46,75) . Several studies investigated glucose metabolism after injection or perfusion with glucagon (43,47,56) , insulin (46,55) or arginine (51,54,55) . There were single studies using each of the following methods: a standard meal as the glucose challenge (57) , a euglycaemic hyperinsulinaemic clamp method (61) and only 24-h C-peptide excretion (53) .…”