title: Born with low birth weight in rural Southern India: what are the metabolic consequences 20 years later?
abstract: OBJECTIVE
  Low 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.
  
  
  METHODS
  One 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.
  
  
  RESULTS
  Men 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 vivo insulin secretion and peripheral insulin action were similar in both the groups. Mothers of the LBW subjects were 3 cm shorter than the control mothers.
  
  
  CONCLUSIONS
  Only 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.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore (CMC), India.
authors.forename: Nihal
authors.initials: N
authors.lastname: Thomas
authors.forename: Louise G
authors.initials: LG
authors.lastname: Grunnet
authors.forename: Pernille
authors.initials: P
authors.lastname: Poulsen
authors.forename: Solomon
authors.initials: S
authors.lastname: Christopher
authors.forename: Rachaproleu
authors.initials: R
authors.lastname: Spurgeon
authors.forename: Mercy
authors.initials: M
authors.lastname: Inbakumari
authors.forename: Roshan
authors.initials: R
authors.lastname: Livingstone
authors.forename: Reginald
authors.initials: R
authors.lastname: Alex
authors.forename: Venkataraghava R
authors.initials: VR
authors.lastname: Mohan
authors.forename: Belavendra
authors.initials: B
authors.lastname: Antonisamy
authors.forename: Finney S
authors.initials: FS
authors.lastname: Geethanjali
authors.forename: Rajni
authors.initials: R
authors.lastname: Karol
authors.forename: Allan
authors.initials: A
authors.lastname: Vaag
authors.forename: Ib C
authors.initials: IC
authors.lastname: Bygbjerg
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001837:Body Weights and Measures; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008660:Metabolism / Q000502:physiology*; D036801:Parturition / Q000502:physiology; D012424:Rural Population / Q000706:statistics & numerical data; D013997:Time Factors; D055815:Young Adult