Abstract

This study aimed to assess whether weight, length, and conditional growth during the first year are associated with glycemia and insulin resistance among young adults. A non-concurrent longitudinal design was used in the study. This is a population-based cohort study, composed of people aged from 22 to 28 years. We estimated z-scores from birth to the first year and the infants were classified as stunted, underweight, overweight, obese, wasted, and at risk of wasting, using cut-offs proposed by the World Health Organization (Child Growth Standards, 2006). Conditional weight and length gain variables were estimated. Glycemia, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and single point insulin sensitivity estimator (SPISE) were evaluated in adulthood. Multiple linear regressions that includes the variables associated with glycemia and insulin resistance were used. In total, 1,070 subjects were evaluated and glycemia in adulthood was higher among subjects who were wasted or at risk of wasting at 12 months (β coefficient = 2.77; 95%CI: 0.37; 5.21). In relation to normal weight, those subjects who were overweight at 12 months showed the lowest glycemia (β coefficient = -2.39; 95%CI: -4.32; -0.36). Conditional weight gain in the first year was negatively associated with glycemia in adulthood (β coefficient = -0.65; 95%CI: -1.23; -0.08). SPISE was higher among underweight subjects, and negatively associated with conditional relative weight gain and conditional linear growth in the first year. In conclusion, we found that undernutrition and suboptimal growth were associated with higher glycemia.

Highlights

  • The prevalence of noncommunicable diseases (NCDs), such as type 2 diabetes mellitus, reached epidemic proportions worldwide

  • Wasting individuals and at risk of wasting at their first year was positively associated with glycemia, on the other hand, overweight and obesity was only negatively associated with glycemia

  • Independent of birth weight, relative weight gain from 0 to 12 months was negatively associated with glycemia and single point insulin sensitivity estimator (SPISE)

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Summary

Introduction

The prevalence of noncommunicable diseases (NCDs), such as type 2 diabetes mellitus, reached epidemic proportions worldwide. In the natural history of this disease, there are three developmental stages: compensatory hyperinsulinemia, prediabetes, and diabetes. The insulin resistance is present, but the β-cell mass retains the ability to synthesize insulin in adequate amounts for metabolic requirements. In the second stage, fasting glycemia values can be higher than 100mg/dL, but never exceeds 126mg/dL. In the third stage, there are manifest disorders of carbohydrate metabolism, and fasting glycemia at any time of the day is higher than 126mg/dL 1,2,3,4,5. The recognition of insulin resistance in persons at risk is significant to implement preventive measures, since type 2 diabetes mellitus causes major health care costs and burden for the patient. Single point insulin sensitivity estimator (SPISE) is another formula to calculate IR and smaller scores are associated with insulin resistance 8

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