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Glucose metabolism in adult survivors of severe acute malnutrition

Glucose metabolism in adult survivors of severe acute malnutrition
Glucose metabolism in adult survivors of severe acute malnutrition
Context and Objectives:

The clinical syndromes of severe acute malnutrition may have early life origins because children with marasmus have lower birth weight than those with kwashiorkor. We hypothesized that resultant metabolic effects may persist into adulthood. We investigated whether marasmus survivors (MS) are more insulin resistant and glucose intolerant than kwashiorkor survivors (KS).

Research Design and Setting:

This was a case-control study in Jamaican adults.

Subjects:

We performed oral glucose tolerance tests on 191 adults (aged 17–50 y; 52% male; body mass index 24.2 ± 5.5 kg/m2). There were 43 MS; 38 KS; 70 age-, sex-, and body mass index-matched community controls; and 40 age- and birth weight-matched controls.

Measurements:

We measured insulin sensitivity with the whole-body insulin sensitivity index, and ?-cell function with the insulinogenic index and the oral disposition index.

Results:

Fasting glucose was comparable across groups, but glucose intolerance was significantly more common in MS (19%) than in KS (3%), community controls (11%), and birth weight-matched controls (10%). The whole-body insulin sensitivity index was lower in MS than KS (P = .06) but similar between MS and controls. The insulinogenic index and oral disposition index were lower in MS compared with all three groups (P < .01).

Conclusions:

Marasmus survivors tend to be less insulin sensitive, but have significantly lower insulin secretion and are more glucose intolerant compared with kwashiorkor survivors and controls. This suggests that poor nutrition in early life causes ?-cell dysfunction, which may predispose to the development of diabetes.
0021-972X
2233-2240
Francis-Emmanuel, P.M.
849b3079-508c-4594-9a1f-2621df24786b
Thompson, D.S.
d8ee1bef-0f10-48af-8a29-8bc1ff267688
Barnett, A.T.
1cef621a-ca35-4917-8def-678a0c123b58
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Byrne, C.D.
1370b997-cead-4229-83a7-53301ed2a43c
Hanson, M.A.
1952fad1-abc7-4284-a0bc-a7eb31f70a3f
Gluckman, P.D.
492295c0-ef71-4871-ad5a-771c98e1059a
Forrester, T.E.
bb3a3675-9204-4743-b4e0-f8d0ddd55932
Boyne, M.S.
4f1a8543-68dd-4e6a-a75c-013faca58a91
Francis-Emmanuel, P.M.
849b3079-508c-4594-9a1f-2621df24786b
Thompson, D.S.
d8ee1bef-0f10-48af-8a29-8bc1ff267688
Barnett, A.T.
1cef621a-ca35-4917-8def-678a0c123b58
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Byrne, C.D.
1370b997-cead-4229-83a7-53301ed2a43c
Hanson, M.A.
1952fad1-abc7-4284-a0bc-a7eb31f70a3f
Gluckman, P.D.
492295c0-ef71-4871-ad5a-771c98e1059a
Forrester, T.E.
bb3a3675-9204-4743-b4e0-f8d0ddd55932
Boyne, M.S.
4f1a8543-68dd-4e6a-a75c-013faca58a91

Francis-Emmanuel, P.M., Thompson, D.S., Barnett, A.T., Osmond, C., Byrne, C.D., Hanson, M.A., Gluckman, P.D., Forrester, T.E. and Boyne, M.S. (2014) Glucose metabolism in adult survivors of severe acute malnutrition. Journal of Clinical Endocrinology & Metabolism, 99 (6), 2233-2240. (doi:10.1210/jc.2013-3511). (PMID:24517147)

Record type: Article

Abstract

Context and Objectives:

The clinical syndromes of severe acute malnutrition may have early life origins because children with marasmus have lower birth weight than those with kwashiorkor. We hypothesized that resultant metabolic effects may persist into adulthood. We investigated whether marasmus survivors (MS) are more insulin resistant and glucose intolerant than kwashiorkor survivors (KS).

Research Design and Setting:

This was a case-control study in Jamaican adults.

Subjects:

We performed oral glucose tolerance tests on 191 adults (aged 17–50 y; 52% male; body mass index 24.2 ± 5.5 kg/m2). There were 43 MS; 38 KS; 70 age-, sex-, and body mass index-matched community controls; and 40 age- and birth weight-matched controls.

Measurements:

We measured insulin sensitivity with the whole-body insulin sensitivity index, and ?-cell function with the insulinogenic index and the oral disposition index.

Results:

Fasting glucose was comparable across groups, but glucose intolerance was significantly more common in MS (19%) than in KS (3%), community controls (11%), and birth weight-matched controls (10%). The whole-body insulin sensitivity index was lower in MS than KS (P = .06) but similar between MS and controls. The insulinogenic index and oral disposition index were lower in MS compared with all three groups (P < .01).

Conclusions:

Marasmus survivors tend to be less insulin sensitive, but have significantly lower insulin secretion and are more glucose intolerant compared with kwashiorkor survivors and controls. This suggests that poor nutrition in early life causes ?-cell dysfunction, which may predispose to the development of diabetes.

Full text not available from this repository.

More information

e-pub ahead of print date: 11 February 2014
Published date: June 2014
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 366419
URI: http://eprints.soton.ac.uk/id/eprint/366419
ISSN: 0021-972X
PURE UUID: baff512d-d7ee-427d-aca5-ffc5ba722bba
ORCID for C. Osmond: ORCID iD orcid.org/0000-0002-9054-4655
ORCID for C.D. Byrne: ORCID iD orcid.org/0000-0001-6322-7753
ORCID for M.A. Hanson: ORCID iD orcid.org/0000-0002-6907-613X

Catalogue record

Date deposited: 27 Jun 2014 11:14
Last modified: 18 Feb 2021 16:55

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Contributors

Author: P.M. Francis-Emmanuel
Author: D.S. Thompson
Author: A.T. Barnett
Author: C. Osmond ORCID iD
Author: C.D. Byrne ORCID iD
Author: M.A. Hanson ORCID iD
Author: P.D. Gluckman
Author: T.E. Forrester
Author: M.S. Boyne

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