Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children’s Study

  • Yajnik C
  • Katre P
  • Joshi S
 et al. 
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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. © 2015, The Author(s).

Author-supplied keywords

  • Cardiovascular risk
  • Childhood insulin resistance
  • Diabetes
  • Indians
  • Young adults

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  • C S Yajnik

  • P A Katre

  • S M Joshi

  • K Kumaran

  • D S Bhat

  • H G Lubree

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