Childhood growth and future risk of the metabolic syndrome in normal-weight men and women.

AIM: The aim of this study was to examine the effects of early growth on the risk of developing the metabolic syndrome in normal-weight individuals. METHODS: We examined 2003 subjects born in Helsinki, Finland, between 1934 and 1944, focusing on 588 individuals who were normal weight (body mass index [BMI] less than or equal to 25 kg/m(2)). These subjects had a median of seven measurements of height and weight from birth to 2 years, and eight measurements from 2 to 11 years of age. The metabolic syndrome was defined according to the 2005 criteria of the International Diabetes Federation. RESULTS: Individuals with the metabolic syndrome were heavier, had higher mean BMI and higher body fat percentages than those without the syndrome. No differences were seen in body size at birth and at 2 years but, by the age of 7 years, those men who later developed the metabolic syndrome were thinner (P=0.01). Changes in BMI during infancy were predictive of the syndrome, with an OR of 0.57 (95% CI: 0.36-0.90) per one S.D. increase in BMI from birth to 2 years. In women, these associations paralleled those in men, but did not reach statistical significance. CONCLUSION: Among normal-weight men, those who developed the metabolic syndrome in adulthood had smaller gains in BMI during infancy and were thinner at age 7 years. These results support findings that early growth may play an important role in the development of the metabolic syndrome.

Role of childhood growth on the risk of metabolic syndrome in obese men and women.

AIM: Although obesity is the key characteristic of the metabolic syndrome, not all obese individuals develop the syndrome. Our aim was to identify characteristics of early growth that protect these individuals from the metabolic syndrome. METHODS: We examined 2003 subjects born in Helsinki, Finland, between 1934 and 1944. We focused on the 499 who were obese (BMI> or =30 kg/m(2)), 400 of whom had the metabolic syndrome according to IDF 2005 criteria. The subjects had a median of seven measurements of height and weight from birth to two years of age, and eight measurements from two to 11 years of age. RESULTS: Among obese individuals, those with the metabolic syndrome had a higher mean body mass index (BMI) and larger waist circumference than those who did not. The two groups were similar in body size at birth but, by two years of age, those who later developed the metabolic syndrome were lighter and thinner, and remained so up to age 11 years. The period when BMI changes were predictive of the syndrome was from birth to seven years. OR was 0.72 (95% CI: 0.57-0.92) per 1 S.D. increase in BMI from birth to two years and 0.63 (95% CI: 0.49-0.81) per 1 S.D. increase in BMI from two to seven years. CONCLUSION: Among obese individuals, those who develop the metabolic syndrome were lighter and thinner from the age of two to 11 years compared with those who did not. These findings support the importance of early childhood growth in determining the metabolic consequences of obesity.

Effects of sympatholytic therapy on insulin sensitivity indices in hypertensive postmenopausal women.

Cardiovascular risk factors are often ineffectively controlled in hypertensive postmenopausal women, and moreover, some antihypertensive drugs may increase particular risk factors such as insulin resistance. In a multicenter, multinational (Finland, Sweden, Lithuania), double-blind, prospectively randomized study hypertensive obese postmenopausal women without hormone therapy (n = 98) were randomly assigned to receive treatment with either the centrally acting agent moxonidine, 0.6 mg/day, or with the peripherally acting atenolol, 50 mg/day, for 8 weeks. In addition to blood pressure measurements, insulin sensitivity was estimated by the quantitative insulin sensitivity check index (QUICKI) and by the insulin sensitivity index (ISI-Matsuda). Subgroup analysis in insulin-resistant women (fasting P-insulin > or = 10 mU/l) and blood pressure responders (diastolic blood pressure < or = 90 mmHg and/or reduction of blood pressure > or = 10 mmHg) were also carried out. Both atenolol and moxonidine led to a significant reduction in diastolic blood pressure of 9.5 mmHg and 6.2 mmHg, respectively. Among insulin-resistant women, an increase in the insulin sensitivity assessed by ISI was improved with moxonidine treatment (p = 0.025). A decrease in insulin sensitivity assessed by QUICKI was observed with atenolol treatment in women with fasting insulin level < 10 mU/l. In patients, in whom blood pressure was reduced, an improvement in insulin sensitivity (ISI) was associated with moxonidine treatment (p = 0.019), but not with atenolol treatment. The centrally acting sympatholytic agent moxonidine did reduce blood pressure somewhat less than atenolol, but it was associated with an improved metabolic profile in terms of decreased insulin resistance both in insulin-resistant postmenopausal women and in women with a significant blood pressure response.

Birth size, adult body composition and muscle strength in later life.

OBJECTIVE: Low birth weight has been linked to lower lean body mass and abdominal obesity later in life, whereas high birth weight has been suggested to predict later obesity as indicated by high body mass index (BMI). We examined how birth weight was related to adult body size, body composition and grip strength. DESIGN/SUBJECTS: Cross-sectional study on 928 men and 1075 women born in 1934-1944, with measurements at birth recorded. MEASUREMENTS: Height, weight, waist and hip circumference and isometric grip strength were measured. Lean and fat body mass were estimated by bioelectrical impedance with an eight-polar tactile electrode system. RESULTS: A 1 kg increase in birth weight corresponded in men to a 4.1 kg (95% CI: 3.1, 5.1) and in women to a 2.9 kg (2.1, 3.6) increase in adult lean mass. This association remained significant after adjustment for age, adult body size, physical activity, smoking status, social class and maternal size. Grip strength was positively related to birth weight through its association with lean mass. The positive association of birth weight with adult BMI was explained by its association with lean mass. Low birth weight was related to higher body fat percentage only after adjustment for adult BMI. Abdominal obesity was not predicted by low birth weight. CONCLUSIONS: Low birth weight is associated with lower lean mass in adult life and thus contributes to the risk of relative sarcopenia and the related functional inability at the other end of the lifespan. At a given level of adult BMI, low birth weight predicts higher body fat percentage.

Prevalence of diabetes and impaired glucose regulation in 45- to 64-year-old individuals in three areas of Finland.

AIMS: To determine the prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) and possible regional differences in Finnish adults aged between 45 and 64 years. METHODS: A population sample of 2642 subjects aged between 45 and 64 years living in three geographical areas in Finland was invited to an oral glucose tolerance test. RESULTS: The glucose tolerance status of 2087 subjects (79.0%) was determined. The age-standardized prevalence of DM in men and women was 10.2% and 7.4%, respectively (P = 0.020 for difference between sexes), and that of IGT 10.5% in men and 9.2% in women. IFG in men was more than twice as common as in women (13.5% vs. 5.0%, respectively, P < 0.001). Abnormal glucose tolerance was most common in southern compared with southwestern and eastern Finland. Of all diabetic subjects, 44% were previously undiagnosed. CONCLUSIONS: The age-standardized prevalence of DM in 45- to 64-year-old Finns was within the range defined in previous studies on Europid populations. DM and IFG were more common in men than in women. Regional differences in the prevalence of abnormal glucose regulation suggest differences in lifestyle within an ethnically homogenous population.