The Effect of Foetal And Early Childhood Growth on Metabolic Derangements of Sri Lankan Children

Abstract Background Studies have shown that accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The aim of this study was to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka Materials: A school-based cross-sectional study was conducted among 5–15 year old children selected using a two-stage probability-proportionate-to-size cluster sampling technique. Birthweight (BW) was extracted from records to denote prenatal growth; and body mass index (BMI) and fat mass (FM) measured to denote the current growth of children. As metabolic parameters, fasting and random blood glucose, lipid profile and blood pressure (BP) were measured. The sample was stratified by age (5–10 years and 11–15 years); and each age group further categorized into tertiles of BW and BMI. Based on these two parameters, metabolic parameters were evaluated within each age category. Results The sample comprised 833 (494 boys). Metabolic parameters did not significantly differ by sex or across BW tertiles of each BMI tertile. However, significant increases were noted in all except FBS across the BMI tertiles of each BW tertile. Children belonging to the lowest BW and highest BMI tertiles had worst metabolic profiles, while those in the lowest BW as well as BMI tertile were protected. Changes were more significant in the older age category. Irrespective of BW, fat deposition rather than nutritional growth seemed to move children to higher BMI tertiles. Conclusion Poor prenatal growth is not the sole risk factor for abnormal metabolic profile found in childhood. Those who gain weight during early childhood are at higher risk than those who remain small. This favours the accelerated postnatal growth hypothesis.