Published in:
Open Access 01-07-2015 | Article
Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children’s Study
Published in: Diabetologia | Issue 7/2015
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Aims/hypothesis
The Pune Children’s Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood.
Methods
We followed up 357 participants (75% follow-up) at 21 years of age who had undergone detailed measurements at 8 years of age (glucose, insulin, HOMA-IR and other indices). Oral glucose tolerance, anthropometry, plasma lipids, BP, carotid intima–media thickness (IMT) and arterial pulse wave velocity (PWV) were measured at 21 years.
Results
Higher fasting glucose, insulin and HOMA-IR at 8 years predicted higher glucose, insulin, HOMA-IR, BP, lipids and IMT at 21 years. A 1 SD change in 8 year variables was associated with a 0.10–0.27 SD change at 21 years independently of obesity/adiposity at 8 years of age. A greater rise in glucose–insulin variables between 8 and 21 years was associated with higher cardiovascular risk factors, including PWV. Participants whose HOMA-IR measurement remained in the highest quartile (n = 31) had a more adverse cardiovascular risk profile compared with those whose HOMA-IR measurement remained in the lowest quartile (n = 28).
Conclusions/interpretation
Prepubertal glucose–insulin metabolism is associated with adult cardiovascular risk and markers of atherosclerosis. Our results support interventions to improve glucose–insulin metabolism in childhood to reduce cardiovascular risk in later life.