Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children's Study.
OBJECTIVE
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
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.
Kamalnayan Bajaj Diabetology Research Centre, Diabetes Unit, King Edward Memorial Hospital Research Centre, Rasta Peth, Pune, 411011, India, diabetes@kemdiabetes.org.
Chittaranjan S
CS
Yajnik
Prachi A
PA
Katre
Suyog M
SM
Joshi
Kalyanaraman
K
Kumaran
Dattatray S
DS
Bhat
Himangi G
HG
Lubree
Nilam
N
Memane
Arun S
AS
Kinare
Anand N
AN
Pandit
Sheila A
SA
Bhave
Ashish
A
Bavdekar
Caroline H D
CH
Fall
D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007194:India / Q000453:epidemiology; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000453:epidemiology; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D055815:Young Adult
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids