Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort.

BACKGROUND & OBJECTIVES: Abnormal endothelial function represents a preclinical marker of atherosclerosis. This study was conducted to evaluate associations between anthropometry, cardiometabolic risk factors, and early life factors and adult measures of endothelial function in a young urban Indian cohort free of clinical cardiovascular disease. METHODS: Absolute changes in brachial artery diameter following cuff inflation and sublingual nitroglycerin (400 µg) were recorded to evaluate endothelium-dependent and -independent measures of endothelial function in 600 participants (362 men; 238 women) from the New Delhi Birth Cohort (2006-2009). Data on anthropometry, cardiometabolic risk factors, medical history, socio-economic position, and lifestyle habits were collected. Height and weight were recorded at birth, two and 11 yr of age. Age- and sex-adjusted linear regression models were developed to evaluate these associations. RESULTS: The mean age of participants was 36±1 yr. Twenty two per cent men and 29 per cent women were obese (BMI th > 30 kg/m [2] ). Mean systolic blood pressure (SBP) was 131±14 and 119±13 mmHg, and diabetes prevalence was 12 and 8 per cent for men and women, respectively. Brachial artery diameter was higher for men compared with women both before (3.48±0.37 and 2.95±0.35 cm) and after hyperaemia (3.87±0.37 vs. 3.37±0.35 cm). A similar difference was seen before and after nitroglycerin. Markers of increased adiposity, smoking, SBP, and metabolic syndrome, but not early life anthropometry, were inversely associated with endothelial function after adjustment for age and sex. INTERPRETATION & CONCLUSIONS: The analysis of the current prospective data from a young urban Indian cohort showed that cardiometabolic risk factors, but not early life anthropometry, were associated with worse endothelial function.

Growth from birth to adulthood and peak bone mass and density data from the New Delhi Birth Cohort.

UNLABELLED: Growth in early life may predict adult bone health. Our data showed that greater height and body mass index (BMI) gain in utero and infancy are associated with higher peak bone mass, and greater BMI gain in childhood/adolescence with higher peak bone density. These associations are mediated by attained adult height and BMI. INTRODUCTION: To study the relationship of height and BMI during childhood with adult bone mineral content (BMC), areal density (aBMD) and apparent density (BMAD, estimated volumetric density). METHODS: Participants comprised 565 men and women aged 33-39 years from the New Delhi Birth Cohort, India, whose weight and height were recorded at birth and annually during infancy (0-2 years), childhood (2-11 years) and adolescence (11 years-adult). Lumbar spine, femoral neck and forearm BMC and aBMD were measured using dual X-ray absorptiometry; lumbar spine and femoral neck BMAD were calculated. RESULTS: Birth length, and height and height gain during infancy, childhood and adolescence were positively correlated with adult BMC (p≤0.01 all sites except birth length with femoral neck). Correlations increased with height from birth to 6 years, then remained constant for later height measurements. There were no associations with BMAD. BMI at birth, and during childhood and adolescence was also positively correlated with BMC (p < 0.01 all sites). BMI at 11 years, and BMI gain in childhood and adolescence, were correlated with aBMD and BMAD (p < 0.001 for all); these correlations strengthened with increasing age of BMI measurement. The associations with height and BMI in early life became non-significant after adjustment for adult height and BMI. CONCLUSIONS: Greater skeletal growth and BMI gain in utero and during infancy are associated with higher peak BMC, and greater BMI gain in childhood and adolescence is associated with higher peak aBMD and BMAD. These associations are mediated by the attainment of adult height and BMI, respectively.

Predicting adult metabolic syndrome from childhood body mass index: follow-up of the New Delhi birth cohort.

OBJECTIVES: To assess whether serial measurements of childhood body mass index (BMI) give clinically useful predictions of the risk of developing adult metabolic syndrome and impaired glucose tolerance or type 2 diabetes. DESIGN/SETTING: Follow-up of a community-based birth cohort in Delhi, India. PARTICIPANTS: 1492 men and women aged 26-32 years whose BMI was recorded 6-monthly throughout childhood. MAIN OUTCOME MEASURES: The predictive value of childhood BMI for adult metabolic syndrome and impaired glucose tolerance (IGT) and diabetes mellitus. RESULTS: 25% of subjects had metabolic syndrome and 15% had IGT/diabetes mellitus. Both outcomes were associated with greater childhood BMI gain (metabolic syndrome: OR 1.63 (95% CI 1.44 to 1.85); IGT/diabetes mellitus: 1.39 (1.20 to 1.60) per unit increase in within-cohort BMI SD score between 5 and 14 years). The best predictions of adult disease were obtained using a combined test comprising (i) any increase in BMI SD score between 5 and 14 years and (ii) a BMI SD score >0 at 14 years (metabolic syndrome: sensitivity 45%, specificity 78%; IGT/diabetes mellitus: 37%, 73%). Likelihood ratios were low (metabolic syndrome: 1.4-2.0; IGT/diabetes mellitus: 1.2-1.4). A single high BMI measurement at 14 years (overweight or obese, according to International Obesity Task Force criteria) was highly specific but insensitive (metabolic syndrome: sensitivity 7%, specificity 97%; IGT/diabetes mellitus: 8%, 97%). Charts for plotting BMI SD scores through childhood were produced. CONCLUSIONS: Serial measurements of childhood BMI give useful predictions of adult risk and could guide advice to children and parents on preventing later disease.