Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians
India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS). PMNS is a community-based intergenerational bi...
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| Veröffentlicht in: | Diabetes care 2021-12, Vol.44 (12), p.2747-2757 |
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| creator | Yajnik, Chittaranjan S Bandopadhyay, Souvik Bhalerao, Aboli Bhat, Dattatray S Phatak, Sanat B Wagh, Rucha H Yajnik, Pallavi C Pandit, Anand Bhave, Sheila Coyaji, Kurus Kumaran, Kalyanaraman Osmond, Clive Fall, Caroline H D |
| description | India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS).
PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and β-cell compensation accounting for prevailing insulin sensitivity.
At 18 years (
= 619), 37% of men and 20% of women were glucose intolerant (prediabetes
= 184; diabetes
= 1) despite 48% being underweight (BMI |
| doi_str_mv | 10.2337/dc20-3026 |
| format | Article |
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PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and β-cell compensation accounting for prevailing insulin sensitivity.
At 18 years (
= 619), 37% of men and 20% of women were glucose intolerant (prediabetes
= 184; diabetes
= 1) despite 48% being underweight (BMI <18.5 kg/m
). Glucose-intolerant participants had higher fasting glucose from childhood. Mothers of glucose-intolerant participants had higher glycemia in pregnancy. Glucose-intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and those with glucose intolerance had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had 2.5- and 4.0-fold higher risks, respectively, of 18-year glucose intolerance; this finding was replicated in two other cohorts.
Inadequate compensatory insulin secretory response to decreasing insulin sensitivity in early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia from childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc20-3026</identifier><identifier>PMID: 34610922</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Beta cells ; Blood glucose ; Blood Glucose - metabolism ; Child ; Childbirth & labor ; Childhood ; Children ; Chromium ; Compensation ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 ; Fasting ; Female ; Glucose ; Glucose Intolerance - epidemiology ; Glucose tolerance ; Glucose Tolerance Test ; Human nutrition ; Humans ; Hyperglycemia ; India - epidemiology ; Insulin ; Insulin Resistance - physiology ; Insulin secretion ; Intolerance ; Male ; Malnutrition ; Men ; Nutrition ; Pregnancy ; Research design ; Secretion ; Sensitivity ; Teenagers ; Undernutrition ; Underweight ; Young adults</subject><ispartof>Diabetes care, 2021-12, Vol.44 (12), p.2747-2757</ispartof><rights>2021 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Dec 1, 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-8d26bd01719abe4b11405005b747ca2cd5889a10b5a2f28800fcff06c3f6d3a33</citedby><cites>FETCH-LOGICAL-c348t-8d26bd01719abe4b11405005b747ca2cd5889a10b5a2f28800fcff06c3f6d3a33</cites><orcidid>0000-0002-2911-2378</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34610922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yajnik, Chittaranjan S</creatorcontrib><creatorcontrib>Bandopadhyay, Souvik</creatorcontrib><creatorcontrib>Bhalerao, Aboli</creatorcontrib><creatorcontrib>Bhat, Dattatray S</creatorcontrib><creatorcontrib>Phatak, Sanat B</creatorcontrib><creatorcontrib>Wagh, Rucha H</creatorcontrib><creatorcontrib>Yajnik, Pallavi C</creatorcontrib><creatorcontrib>Pandit, Anand</creatorcontrib><creatorcontrib>Bhave, Sheila</creatorcontrib><creatorcontrib>Coyaji, Kurus</creatorcontrib><creatorcontrib>Kumaran, Kalyanaraman</creatorcontrib><creatorcontrib>Osmond, Clive</creatorcontrib><creatorcontrib>Fall, Caroline H D</creatorcontrib><title>Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS).
PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and β-cell compensation accounting for prevailing insulin sensitivity.
At 18 years (
= 619), 37% of men and 20% of women were glucose intolerant (prediabetes
= 184; diabetes
= 1) despite 48% being underweight (BMI <18.5 kg/m
). Glucose-intolerant participants had higher fasting glucose from childhood. Mothers of glucose-intolerant participants had higher glycemia in pregnancy. Glucose-intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and those with glucose intolerance had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had 2.5- and 4.0-fold higher risks, respectively, of 18-year glucose intolerance; this finding was replicated in two other cohorts.
Inadequate compensatory insulin secretory response to decreasing insulin sensitivity in early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia from childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.</description><subject>Beta cells</subject><subject>Blood glucose</subject><subject>Blood Glucose - metabolism</subject><subject>Child</subject><subject>Childbirth & labor</subject><subject>Childhood</subject><subject>Children</subject><subject>Chromium</subject><subject>Compensation</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Fasting</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose Intolerance - epidemiology</subject><subject>Glucose tolerance</subject><subject>Glucose Tolerance Test</subject><subject>Human nutrition</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>India - epidemiology</subject><subject>Insulin</subject><subject>Insulin Resistance - physiology</subject><subject>Insulin secretion</subject><subject>Intolerance</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Men</subject><subject>Nutrition</subject><subject>Pregnancy</subject><subject>Research design</subject><subject>Secretion</subject><subject>Sensitivity</subject><subject>Teenagers</subject><subject>Undernutrition</subject><subject>Underweight</subject><subject>Young adults</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0c1u1DAUhmELgehQWHADyBIbkJpy_JfYyypifqRKVIguWEWO7XRSJT6DnQj1RnohXAjXRIaWLlh58-jTsV5C3jI450JUn7zjUAjg5TOyYkaoQimpn5MVMGkKZQw_Ia9yvgUAKbV-SU6ELBkYzlfk_gox0V2k11NISDcJf077M2qjp1-Dn13w9Pevog7DQGscDyFmO_UY_4Jtf7Ona5unPt7QzTA7zIGuE4603veD3yP6M3qRAt3a1C4mpEyxe5K7OOEQko0u0D7S7zgvM7voexvza_Kis0MObx7fU3K9_vyt3haXXza7-uKycELqqdCel60HVjFj2yBbxiQoANVWsnKWO6-0NpZBqyzvuNYAnes6KJ3oSi-sEKfkw8PuIeGPOeSpGfvslt_aGHDODVeVKQXjJV_o-__oLc4pLtc1vAQjmRJVtaiPD8olzDmFrjmkfrTprmHQHGM1x1jNMdZi3z0uzu0Y_JP8V0f8AVHtjws</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Yajnik, Chittaranjan S</creator><creator>Bandopadhyay, Souvik</creator><creator>Bhalerao, Aboli</creator><creator>Bhat, Dattatray S</creator><creator>Phatak, Sanat B</creator><creator>Wagh, Rucha H</creator><creator>Yajnik, Pallavi C</creator><creator>Pandit, Anand</creator><creator>Bhave, Sheila</creator><creator>Coyaji, Kurus</creator><creator>Kumaran, Kalyanaraman</creator><creator>Osmond, Clive</creator><creator>Fall, Caroline H D</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2911-2378</orcidid></search><sort><creationdate>202112</creationdate><title>Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians</title><author>Yajnik, Chittaranjan S ; Bandopadhyay, Souvik ; Bhalerao, Aboli ; Bhat, Dattatray S ; Phatak, Sanat B ; Wagh, Rucha H ; Yajnik, Pallavi C ; Pandit, Anand ; Bhave, Sheila ; Coyaji, Kurus ; Kumaran, Kalyanaraman ; Osmond, Clive ; Fall, Caroline H D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-8d26bd01719abe4b11405005b747ca2cd5889a10b5a2f28800fcff06c3f6d3a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Beta cells</topic><topic>Blood glucose</topic><topic>Blood Glucose - metabolism</topic><topic>Child</topic><topic>Childbirth & labor</topic><topic>Childhood</topic><topic>Children</topic><topic>Chromium</topic><topic>Compensation</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Fasting</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose Intolerance - epidemiology</topic><topic>Glucose tolerance</topic><topic>Glucose Tolerance Test</topic><topic>Human nutrition</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>India - epidemiology</topic><topic>Insulin</topic><topic>Insulin Resistance - physiology</topic><topic>Insulin secretion</topic><topic>Intolerance</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Men</topic><topic>Nutrition</topic><topic>Pregnancy</topic><topic>Research design</topic><topic>Secretion</topic><topic>Sensitivity</topic><topic>Teenagers</topic><topic>Undernutrition</topic><topic>Underweight</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yajnik, Chittaranjan S</creatorcontrib><creatorcontrib>Bandopadhyay, Souvik</creatorcontrib><creatorcontrib>Bhalerao, Aboli</creatorcontrib><creatorcontrib>Bhat, Dattatray S</creatorcontrib><creatorcontrib>Phatak, Sanat B</creatorcontrib><creatorcontrib>Wagh, Rucha H</creatorcontrib><creatorcontrib>Yajnik, Pallavi C</creatorcontrib><creatorcontrib>Pandit, Anand</creatorcontrib><creatorcontrib>Bhave, Sheila</creatorcontrib><creatorcontrib>Coyaji, Kurus</creatorcontrib><creatorcontrib>Kumaran, Kalyanaraman</creatorcontrib><creatorcontrib>Osmond, Clive</creatorcontrib><creatorcontrib>Fall, Caroline H D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yajnik, Chittaranjan S</au><au>Bandopadhyay, Souvik</au><au>Bhalerao, Aboli</au><au>Bhat, Dattatray S</au><au>Phatak, Sanat B</au><au>Wagh, Rucha H</au><au>Yajnik, Pallavi C</au><au>Pandit, Anand</au><au>Bhave, Sheila</au><au>Coyaji, Kurus</au><au>Kumaran, Kalyanaraman</au><au>Osmond, Clive</au><au>Fall, Caroline H D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2021-12</date><risdate>2021</risdate><volume>44</volume><issue>12</issue><spage>2747</spage><epage>2757</epage><pages>2747-2757</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS).
PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and β-cell compensation accounting for prevailing insulin sensitivity.
At 18 years (
= 619), 37% of men and 20% of women were glucose intolerant (prediabetes
= 184; diabetes
= 1) despite 48% being underweight (BMI <18.5 kg/m
). Glucose-intolerant participants had higher fasting glucose from childhood. Mothers of glucose-intolerant participants had higher glycemia in pregnancy. Glucose-intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and those with glucose intolerance had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had 2.5- and 4.0-fold higher risks, respectively, of 18-year glucose intolerance; this finding was replicated in two other cohorts.
Inadequate compensatory insulin secretory response to decreasing insulin sensitivity in early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia from childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>34610922</pmid><doi>10.2337/dc20-3026</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2911-2378</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2021-12, Vol.44 (12), p.2747-2757 |
| issn | 0149-5992 1935-5548 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Beta cells Blood glucose Blood Glucose - metabolism Child Childbirth & labor Childhood Children Chromium Compensation Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 Fasting Female Glucose Glucose Intolerance - epidemiology Glucose tolerance Glucose Tolerance Test Human nutrition Humans Hyperglycemia India - epidemiology Insulin Insulin Resistance - physiology Insulin secretion Intolerance Male Malnutrition Men Nutrition Pregnancy Research design Secretion Sensitivity Teenagers Undernutrition Underweight Young adults |
| title | Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians |
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