Abstract
BackgroundSouth Asian populations develop insulin resistance from a young age. Poor intrauterine growth and increased rates of post natal growth predisposes to develop insulin resistance later in life. This study identifies insulin resistance and relation to birth weight among a group of 5–15 year old children of urban Sri Lanka.MethodsA cross sectional descriptive study, using two-stage probability proportionate cluster sampling technique. After a 12 h overnight fast, blood was drawn for fasting blood glucose and insulin. OGTT was performed with 2 h random blood glucose. Basic anthropometry was assessed and insulin resistance measured by HOMA-IR.ResultsOf 309 children (boys 133) 13 (4.2%) were obese and 35 (11.3%) were overweight. Eight had impaired glucose homeostasis but no diabetes mellitus. The mean (SD) fasting insulin was 37.8 (37.9) and 32.5 (40.4) pmol/L in girls and boys respectively. 2 h post glucose insulin in girls and boys were 258 (324) and 152 (168) pmol/L respectively. The mean HOMA-IR was 1.1 (1.1) and 0.94 (1.2) for girls and boys respectively. The 4th quartile value of HOMA-IR for the whole population was 1.2 (95% CI 1.1, 1.3) and in obese children 2.26 (95% CI 2.0, 3.1). Fasting and 2 h insulin and HOMA-IR was not affected by birth weight but showed significant difference when compared across present BMI tertile with significantly high values in the highest tertile.ConclusionAlthough many children were able to control glucose within normal limits, evidence of early development of insulin resistance was seen. Children born small but became obese, had the highest risk of developing insulin resistance.
Highlights
South Asian populations develop insulin resistance from a young age
Many complications related to obesity such as hypertension [4], dyslipidaemia [5], hepatic steatosis [6] and metabolic syndrome [7] are driven by insulin resistance
Genetic predisposition accompanied with poor intrauterine growth followed by increase growth later in childhood, could probably predispose vulnerable groups to develop insulin resistance later in life
Summary
South Asian populations develop insulin resistance from a young age. Poor intrauterine growth and increased rates of post natal growth predisposes to develop insulin resistance later in life. This study identifies insulin resistance and relation to birth weight among a group of 5–15 year old children of urban Sri Lanka. South Asian populations are affected due to its fast economic growth and genetic predisposition, leading to the development of many adverse metabolic consequences including insulin resistance [1]. Many complications related to obesity such as hypertension [4], dyslipidaemia [5], hepatic steatosis [6] and metabolic syndrome [7] are driven by insulin resistance.
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