The effect of wasting and stunting during severe acute malnutrition in infancy on insulin sensitivity and insulin clearance in adult life
The effect of wasting and stunting during severe acute malnutrition in infancy on insulin sensitivity and insulin clearance in adult life
Adults who had non-edematous severe acute malnutrition (SAM) during infancy (i.e., marasmus) have worse glucose tolerance and beta-cell function than survivors of edematous SAM (i.e., kwashiorkor). We hypothesized that wasting and/or stunting in SAM is associated with lower glucose disposal rate (M) and insulin clearance (MCR) in adulthood. We recruited 40 nondiabetic adult SAM survivors (20 marasmus survivors (MS) and 20 kwashiorkor survivors (KS)) and 13 matched community controls. We performed 150-minute hyperinsulinaemic, euglycaemic clamps to estimate M and MCR. We also measured serum adiponectin, anthropometry, and body composition. Data on wasting (weight-for-height) and stunting (height-for-age) were abstracted from the hospital records. Children with marasmus had lower weight-for-height z-scores (WHZ) (-3.8 ± 0.9 vs. -2.2 ± 1.4; P < 0.001) and lower height-for-age z-scores (HAZ) (-4.6 ± 1.1 vs. -3.4 ± 1.5; P = 0.0092) than those with kwashiorkor. As adults, mean age (SD) of participants was 27.2 (8.1) years; BMI was 23.6 (5.0) kg/m2. SAM survivors and controls had similar body composition. MS and KS and controls had similar M (9.1 ± 3.2; 8.7 ± 4.6; 6.9 ± 2.5 mg.kg-1.min-1 respectively; P = 0.3) and MCR. WHZ and HAZ were not associated with M, MCR or adiponectin even after adjusting for body composition. Wasting and stunting during infancy are not associated with insulin sensitivity and insulin clearance in lean, young, adult survivors of SAM. These data are consistent with the finding that glucose intolerance in malnutrition survivors is mostly due to beta-cell dysfunction.
Malnutrition, infancy, insulin clearance, insulin sensitivity, stunting, wasting
750-756
Thompson, Debbie S.
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Francis-Emmanuel, Patrice M.
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Barnett, Alan T.
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Osmond, Clive
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Hanson, Mark
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Byrne, Christopher
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Gluckman, Peter D.
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Forrester, Terrence E.
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Boyne, Michael S.
5d3a1d97-95de-4ba5-a5f5-f03d1934e608
1 March 2022
Thompson, Debbie S.
87fc1031-a971-441d-b055-d325ce9e1562
Francis-Emmanuel, Patrice M.
a553dc32-8aa5-40d7-8b21-f2c44bcf4e03
Barnett, Alan T.
37ba5018-cc2a-467d-aa63-eba1dda26005
Osmond, Clive
cf3b717a-e970-458b-8e36-2ea108eff0b0
Hanson, Mark
1952fad1-abc7-4284-a0bc-a7eb31f70a3f
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Gluckman, Peter D.
f2fc56bb-fdae-49d5-a1b3-24f435d25856
Forrester, Terrence E.
3b560ab4-8879-4a79-af55-6d1a0e49899d
Boyne, Michael S.
5d3a1d97-95de-4ba5-a5f5-f03d1934e608
Thompson, Debbie S., Francis-Emmanuel, Patrice M., Barnett, Alan T., Osmond, Clive, Hanson, Mark, Byrne, Christopher, Gluckman, Peter D., Forrester, Terrence E. and Boyne, Michael S.
(2022)
The effect of wasting and stunting during severe acute malnutrition in infancy on insulin sensitivity and insulin clearance in adult life.
Journal of Developmental Origins of Health and Disease, 13 (6), .
(doi:10.1017/S2040174422000034).
Abstract
Adults who had non-edematous severe acute malnutrition (SAM) during infancy (i.e., marasmus) have worse glucose tolerance and beta-cell function than survivors of edematous SAM (i.e., kwashiorkor). We hypothesized that wasting and/or stunting in SAM is associated with lower glucose disposal rate (M) and insulin clearance (MCR) in adulthood. We recruited 40 nondiabetic adult SAM survivors (20 marasmus survivors (MS) and 20 kwashiorkor survivors (KS)) and 13 matched community controls. We performed 150-minute hyperinsulinaemic, euglycaemic clamps to estimate M and MCR. We also measured serum adiponectin, anthropometry, and body composition. Data on wasting (weight-for-height) and stunting (height-for-age) were abstracted from the hospital records. Children with marasmus had lower weight-for-height z-scores (WHZ) (-3.8 ± 0.9 vs. -2.2 ± 1.4; P < 0.001) and lower height-for-age z-scores (HAZ) (-4.6 ± 1.1 vs. -3.4 ± 1.5; P = 0.0092) than those with kwashiorkor. As adults, mean age (SD) of participants was 27.2 (8.1) years; BMI was 23.6 (5.0) kg/m2. SAM survivors and controls had similar body composition. MS and KS and controls had similar M (9.1 ± 3.2; 8.7 ± 4.6; 6.9 ± 2.5 mg.kg-1.min-1 respectively; P = 0.3) and MCR. WHZ and HAZ were not associated with M, MCR or adiponectin even after adjusting for body composition. Wasting and stunting during infancy are not associated with insulin sensitivity and insulin clearance in lean, young, adult survivors of SAM. These data are consistent with the finding that glucose intolerance in malnutrition survivors is mostly due to beta-cell dysfunction.
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the-effect-of-wasting-and-stunting-during-severe-acute-malnutrition-in-infancy-on-insulin-sensitivity-and-insulin-clearance-in-adult-life
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More information
Accepted/In Press date: 6 January 2022
e-pub ahead of print date: 1 March 2022
Published date: 1 March 2022
Additional Information:
Funding Information:
This work was supported by the New Zealand Health Research Council Grant 09/052, Developmental Adaptation to an Obesogenic Environment Program. M.A.H. is supported by the British Heart Foundation. CDB is supported in part by the Southampton NIHR Biomedical Research Centre.
Publisher Copyright:
© 2022 The Author(s). Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease.
Keywords:
Malnutrition, infancy, insulin clearance, insulin sensitivity, stunting, wasting
Identifiers
Local EPrints ID: 454727
URI: http://eprints.soton.ac.uk/id/eprint/454727
ISSN: 2040-1744
PURE UUID: b17f5105-997b-43dc-9240-2983c18e69bb
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Date deposited: 22 Feb 2022 17:35
Last modified: 17 Mar 2024 02:51
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Contributors
Author:
Debbie S. Thompson
Author:
Patrice M. Francis-Emmanuel
Author:
Alan T. Barnett
Author:
Clive Osmond
Author:
Peter D. Gluckman
Author:
Terrence E. Forrester
Author:
Michael S. Boyne
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