The New England Journal of Medicine
e-mail icon  FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |    Advanced Search
Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe
 
Original Article
PreviousPrevious
Volume 350:865-875 February 26, 2004 Number 9
NextNext

Relation of Serial Changes in Childhood Body-Mass Index to Impaired Glucose Tolerance in Young Adulthood
Santosh K. Bhargava, M.D., Harshpal Singh Sachdev, M.D., Caroline H.D. Fall, D.M., Clive Osmond, Ph.D., Ramakrishnan Lakshmy, Ph.D., David J.P. Barker, Ph.D., Sushant K. Dey Biswas, M.Stat., Siddharth Ramji, M.D., Dorairaj Prabhakaran, D.M., and Kolli Srinath Reddy, D.M.

 Sign up for free e-toc
 

This Article
-Full Text
- PDF
-PDA Full Text
-PowerPoint Slide Set

Commentary
-Perspective
 by Dietz, W. H.
-Letters

Tools and Services
-Add to Personal Archive
-Add to Citation Manager
-Notify a Friend
-E-mail When Cited
-E-mail When Letters Appear

More Information
-PubMed Citation
ABSTRACT

Background The risk of type 2 diabetes mellitus is increased in people who have low birth weights and who subsequently become obese as adults. Whether their obesity originates in childhood and, if so, at what age are unknown. Understanding the origin of obesity may be especially important in developing countries, where type 2 diabetes is rapidly increasing yet public health messages still focus on reducing childhood "undernutrition."

Methods We evaluated glucose tolerance and plasma insulin concentrations in 1492 men and women 26 to 32 years of age who had been measured at birth and at intervals of three to six months throughout infancy, childhood, and adolescence in a prospective, population-based study.

Results The prevalence of impaired glucose tolerance was 10.8 percent, and that of diabetes was 4.4 percent. Subjects with impaired glucose tolerance or diabetes typically had a low body-mass index up to the age of two years, followed by an early adiposity rebound (the age after infancy when body mass starts to rise) and an accelerated increase in body-mass index until adulthood. However, despite an increase in body-mass index between the ages of 2 and 12 years, none of these subjects were obese at the age of 12 years. The odds ratio for disease associated with an increase in the body-mass index of 1 SD from 2 to 12 years of age was 1.36 (95 percent confidence interval, 1.18 to 1.57; P<0.001).

Conclusions There is an association between thinness in infancy and the presence of impaired glucose tolerance or diabetes in young adulthood. Crossing into higher categories of body-mass index after the age of two years is also associated with these disorders.


Source Information

From the Department of Pediatrics, Sunder Lal Jain Hospital, Delhi, India (S.K.B.); the Department of Pediatrics, Maulana Azad Medical College (H.S.S., S.R.), the Department of Cardiology, All India Institute of Medical Sciences (R.L., D.P., K.S.R.), and the Indian Council of Medical Research (S.K.D.B.) — all in New Delhi, India; and the Medical Research Council Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (C.H.D.F., C.O., D.J.P.B.).

Address reprint requests to Prof. Sachdev at E-6/12 Vasant Vihar, New Delhi 110 057, India, or at hpssachdev{at}hotmail.com.

Full Text of this Article


Related Letters:

The Changing Face and Implications of Childhood Obesity
Barrett T., Ehtisham S., Maher E., Plagemann A., Harder T., Cheng T. O., Sachdev H. S., Fall C. H.D., Osmond C.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:2414-2416, Jun 3, 2004. Correspondence

This article has been cited by other articles:



HOME  |  SUBSCRIBE  |  SEARCH  |  CURRENT ISSUE  |  PAST ISSUES  |  COLLECTIONS  |  PRIVACY  |  TERMS OF USE  |  HELP  |  beta.nejm.org

Comments and questions? Please contact us.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.