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Evidence for impaired insulin production and higher sensitivity in stunted children living in slums

Published online by Cambridge University Press:  08 March 2007

P. A Martins  and
A. L. Sawaya
P. A Martins*
Affiliation:
Department of Physiology, Federal University of São Paulo, Saão Paulo, Brazil
A. L. Sawaya
Affiliation:
Department of Physiology, Federal University of São Paulo, Saão Paulo, Brazil
*
*Corresponding author: Dr Paula A. Martins, fax 55 11 5576427, email [email protected]
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Abstract

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The objective of the present study was to investigate the changes in glucose and insulin metabolism in nutritionally stunted children that can be involved in the appearance of chronic diseases in adulthood. For this purpose, sixty-one children were selected, thirty-five boys and twenty-six girls, residents of slums in S˜o Paulo, Brazil. The children were classified according to the height-for-age as stunted (1·5 Z-score; n 21) or non-stunted (≥1·5 Z-score; n 40). The glucose and insulin plasma levels were determined and, from these values, the indexes that evaluate the pancreatic ·-cell function (homeostasis model assessment (HOMA-B)) and insulin sensitivity (HOMA-S) were assessed. Stunted children showed lower values of fasting insulin than those of the non-stunted group (boys: 29·7 (SD 14·9) v. 5=·4 (SD 29·2) pmol/l, P=·019; girls: 34·4 (SD 12·6) v. 62·3 (SD 28·7) pmol/l, P=·016) but the glucose levels were similar (boys: 4·6 (SD =·3) v. 4·5 (SD =·3) mmol/l; girls: 4·2 (SD =·3) v. 4·4 (SD =·3) mmol/l). Stunted children showed lower HOMA-B values (boys: 83 (SD 22) % v. 115 (SD 36) %, P=·011; girls: 107 (SD 23) % v. 144 (SD 46) %, P=·045) and higher HOMA-S values (boys: 196 (SD 92) % v. 120 (SD 62) %, P=·014; girls: 159 (SD 67) % v· 98 (SD 57) %, P=·016). The results show a decreased activity of μ-cell function and increased insulin sensitivity in stunted children. The decreased b-cell function of this group may strongly predict type 2 diabetes.

Keywords

StuntingUndernutritionInsulin sensitivityβ-Cell functionHOMA
Type
Research Article
Information
British Journal of Nutrition , Volume 95 , Issue 5 , May 2006 , pp. 996 - 1001
Copyright
Copyright © The Nutrition Society 2006

References

Bavdekar, A, Yajnik, CS, Fall, CH, Bapat, S, Pandit, AN, Deshpande, V, Bhave, S, Kellingray, SD & Joglekar, CInsulin resistancesyndrome in 8-year-old Indian children: small at birth, big at 8 years, or both?. Diabetes 1999 48, 2422–2429.CrossRefGoogle Scholar
Bonora, E, Targher, G, Alberiche, M, Bonadonna, RC, Saggiani, F, Zenere, MB, Monauni, T & Muggeo, MHomeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 2000 23, 57–63.CrossRefGoogle ScholarPubMed
Boule, NG, Tremblay, A, Gonzalez-Barranco, J, Aguilar-Salinas, CA, Lopez-Alvarenga, JC, Despres, JP, Bouchard, C, Gomez-Perez, FJ, Castillo-Martinez, L & Rios-Torres, JMInsulin resistance and abdominal adiposity in young men with documented malnutrition during the first year of life. Int J Obes Relat Metab Disord 2003 27, 598–604.CrossRefGoogle ScholarPubMed
Centers for Disease Control (2000) CDC growth charts. http://www.cdc.gov/growthcharts/Google Scholar
Cianfarani, SFoetal origins of adult diseases: just a matter of stem cell number?. Med Hypotheses 2003 61, 401–404.CrossRefGoogle ScholarPubMed
Fernandes, MT, Sesso, R, Martins, PA & Sawaya, ALIncreased blood pressure in adolescents of low socioeconomic status with short stature. Pediatr Nephrol 2003 18, 435–439.CrossRefGoogle ScholarPubMed
Florêncio, TT, Ferreira, HS, Cavalcante, JC, Luciano, SM & Sawaya, ALFood consumed does not account for the higher prevalence of obesity among stunted adults in a very-low-income population in the Northeast of Brazil (Maceio, Alagoas). Eur J Clin Nutr 2003 57, 1437–1446.CrossRefGoogle ScholarPubMed
Florêncio, TT, Ferreira, HS, Cavalcante, JC & Sawaya, ALShort stature, obesity and arterial hypertension in a very low income population in North-eastern Brazil. Nutr Metab Cardiovasc Disr 2004 14, 26–33.CrossRefGoogle Scholar
Florêncio, TM, Ferreira, HS, de Franca, AP, Cavalcante, JC & Sawaya, ALObesity and undernutrition in a very-lowincome population in the city of Maceio, northeastern Brazil. Br J Nutr 2001 86, 277–284.CrossRefGoogle Scholar
Grillo, LP, Siqueira, AF, Silva, AC, Martins, PA, Vereschi, IT & Sawaya, ALLower resting metabolic rate and higher velocity of weight gain in a prospective study of stunted vs nonstunted girls living in the shantytowns of Sao Paulo, Brazil. Eur J Clin Nutr 2005 59, 835–842.CrossRefGoogle Scholar
Gungor, N, Saad, R, Janosky, J & Arslanian, SValidation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatr 2004 144, 47–55.CrossRefGoogle ScholarPubMed
Hales, CN, Desai, M, Ozanne, SE & Crowther, NJFishing in the stream of diabetes: from measuring insulin to the control of fetal organogenesis. Biochem Soc Trans 1996 24, 341–350.CrossRefGoogle Scholar
Hoffman, DJ, Roberts, SB, Verreschi, I, Martins, PA, de Nascimento, C, Tucker, KL & Sawaya, ALRegulation of energy intake may be impaired in nutritionally stunted children from the shantytowns of Sao Paulo, Brazil. J Nutr 2000a 130, 2265–2270.Google ScholarPubMed
Hoffman, DJ, Sawaya, AL, Coward, WA, Wright, A, Martins, PA, , , de Nascimento, C, Tucker, KL & Roberts, SBEnergy expenditure of stunted and nonstunted boys and girls living in the shantytowns of Sao Paulo, Brazil. Am J Clin Nutr 2000b 72, 1025–1031.CrossRefGoogle ScholarPubMed
Hoffman, DJ, Sawaya, AL, Verreschi, I, Tucker, KL & Roberts, SBWhy are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from Sao Paulo, Brazil. Am J Clin Nutr 2000c 72, 702–707.CrossRefGoogle ScholarPubMed
Holemans, K, Aerts, L & Van Assche, FALifetime consequences of abnormal fetal pancreatic development. J Physiol 2003 15, 11–20.CrossRefGoogle Scholar
Holness, MJImpact of early growth retardation on glucoregulatory control and insulin action in mature rats. Am J Physiol 1996 270, 946–954.Google ScholarPubMed
Jaquet, D, Gaboriau, A, Czernichow, P & Levy-Marchal, CInsulin resistance early in adulthood in subjects born with intra-uterine growth retardation. J Clin Endocrinol Metab 2000 85, 1401–1406.Google Scholar
Langley, SC, Browne, RF & Jackson, AAAltered glucose tolerance in rats exposed to maternal low protein diets in utero. Comp Biochem Physiol A Mol Integr Physiol 1994 109, 223–229.CrossRefGoogle ScholarPubMed
Levy, JC, Matthews, DR & Hermans, MPCorrect homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care 1998 21, 2191–2192.CrossRefGoogle ScholarPubMed
Lithell, HO, McKeigue, PM, Berglund, L, Mohsen, R, Lithell, UB & Leon, DARelation of size at birth to non-insulin dependent diabetes and insulin concentrations in men aged 50–60 years. Br Med J 1996 312, 406–410.CrossRefGoogle ScholarPubMed
Martins, PA, Hoffman, DJ, Fernandes, MT, Nascimento, CR, Roberts, SB, Sesso, R & Sawaya, ALStunted children gain less lean body mass and more fat mass than their non-stunted counterparts: a prospective study. Br J Nutr 2004 92, 819–825.CrossRefGoogle ScholarPubMed
Matthews, DR, Hosker, JP, Rudenski, AS, Naylor, BA, Treacher, DF & Turner, RCHomeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985 28, 412–419.CrossRefGoogle ScholarPubMed
Moore, SE, Halsall, I, Howarth, D, Poskitt, EM & Prentice, AMGlucose, insulin and lipid metabolism in rural Gambians exposed to early malnutrition. Diabet Med 2001 18, 646–653.CrossRefGoogle ScholarPubMed
Moura, AS, Caldeira Filho, JS, de Freitas, MPC & de Sá, CCInsulin secretion impairment and insulin sensitivity improvement in adult rats undernourished during early lactation. Res Commun Mol Pathol Pharmacol 1997 96, 179–192.Google ScholarPubMed
Moura, AS, Carpinelli, AR, Barbosa, FB, Gravena, C & Mathias, PCUndernutrition during early lactation as an alternative model to study the onset of diabetes mellitus type II. Res Commun Mol Pathol Pharmacol 1996 92, 73–84.Google Scholar
Ozanne, SE & Hales, CNEarly programming of glucose–insulin metabolism. Trends Endocrinol Metab 2002 13, 368–373.CrossRefGoogle ScholarPubMed
Ozanne, SE, Olsen, GS, Hansen, LL, Tingey, KJ, Nave, BT, Wang, CL, Hartil, K, Petry, CJ, Buckley, AJ & Mosthaf-Seedorf, LEarly growth restriction leads to down regulation of protein kinase C zeta and insulin resistance in skeletal muscle. J Endocrinol 2003 177, 235–241.CrossRefGoogle ScholarPubMed
Ozanne, SE, Wang, CL, Coleman, N & Smith, GDAltered muscle insulin sensitivity in the male offspring of protein-malnourished rats. Am J Physiol 1996 271, 1128–1134.Google ScholarPubMed
Petry, CJ, Dorling, MW, Pawlak, DB, Ozanne, SE & Hales, CNDiabetes in old male offspring of rat dams fed a reduced protein diet. Int J Exp Diabetes Res 2001 2, 139–143.CrossRefGoogle ScholarPubMed
Petry, CJ, Ozanne, SE, Wang, CL & Hales, CNEarly protein restriction and obesity independently induce hypertension in 1-year-old rats. Clin Sci 1997 93, 147–152.CrossRefGoogle ScholarPubMed
Phillips, DIWInsulin resistance as a programmed response to fetal undernutrition. Diabetologia 1996 39, 1119–1122.CrossRefGoogle ScholarPubMed
Picarel-Blanchot, F, Alvarez, C, Bailbe, D, Pascual-Leone, AM & Portha, BChanges in insulin action and insulin secretion in the rat after dietary restriction early in life: influence of food restriction versus low-protein food restriction. Metabolism 1995 44, 1519–1526.CrossRefGoogle ScholarPubMed
Ravelli, AC, van der Meulen, JH, Michels, RP, Osmond, C, Barker, DJ, Hales, CN & Bleker, OPGlucose tolerance in adults after prenatal exposure to famine. Lancet 1998 351, 173–177.CrossRefGoogle ScholarPubMed
Tanner, JMThe development of the reproductive system. In Growth at Adolescence, 2nd ed. pp. 28–39Oxford: Blackwell Scientific Publications. 1962Google Scholar
Uwaifo, GI, Fallon, EM, Chin, J, Elberg, J, Parikh, SJ & Yanovski, JÁIndices of insulin action, disposal, and secretion derived from fasting samples and clamps in normal glucose-tolerant black and white children. Diabetes Care 2002 25, 2081–2087.CrossRefGoogle ScholarPubMed
Van Assche, FA, de Prins, F, Aerts, L & Verjans, MThe endocrine pancreas in small-for-dates infants. Br J Obstet Gynaecol 1977 84, 751–753.CrossRefGoogle ScholarPubMed
Wallace, TM, Levy, JC & Matthews, DRUse and abuse of HOMA modeling. Diabetes Care 2004 27, 1487–1495.CrossRefGoogle ScholarPubMed
Waterlow, JCProtein-energy malnutrition: general introduction. In Protein Energy Malnutrition, pp. 1–13. London: Edward Arnold. 1992Google Scholar
World Health Organization Physical Status: The Use and Interpretation of Anthropometry. Technical Report Series no.854. Geneva: WHO. 1995Google Scholar
Yajnik, CSEarly life origins of insulin resistance and type 2 diabetes in India and other Asian countries. J Nutr 2004 134, 205–210.CrossRefGoogle ScholarPubMed