Adult Metabolic Syndrome and Impaired Glucose Tolerance Are Associated With Different Patterns of BMI Gain During Infancy

Data from the New Delhi birth cohort

  1. Caroline H.D. Fall, DM1,
  2. Harshpal Singh Sachdev, MD2,
  3. Clive Osmond, PHD1,
  4. Ramakrishnan Lakshmy, PHD3,
  5. Sushant Dey Biswas, MSTAT4,
  6. Dorairaj Prabhakaran, DM5,
  7. Nikhil Tandon, MD, PHD3,
  8. Siddharth Ramji, MD6,
  9. K. Srinath Reddy, DM7,
  10. David J.P. Barker, PHD1 and
  11. Santosh K. Bhargava, MD8
  1. 1MRC Epidemiology Resource Centre, Southampton, U.K.
  2. 2Sitaram Bhartia Institute of Science and Research, New Delhi, India
  3. 3All India Institute of Medical Sciences, New Delhi, India
  4. 4Indian Council of Medical Research, New Delhi, India
  5. 5Centre for Chronic Disease Control, New Delhi, India
  6. 6Maulana Azad Medical College, New Delhi, India
  7. 7Public Health Foundation of India, New Delhi, India
  8. 8Sunder Lal Jain Hospital, New Delhi, India
  1. Corresponding author: Caroline H.D. Fall, chdf{at}


OBJECTIVE—The purpose of this study was to describe patterns of infant, childhood, and adolescent BMI and weight associated with adult metabolic risk factors for cardiovascular disease.

RESEARCH DESIGN AND METHODS—We measured waist circumference, blood pressure, glucose, insulin and lipid concentrations, and the prevalence of metabolic syndrome (National Cholesterol Education Program Adult Treatment Panel III definition) in 1,492 men and women aged 26–32 years in Delhi, India, whose weight and height were recorded every 6 months throughout infancy (0–2 years), childhood (2–11 years), and adolescence (11 years–adult).

RESULTS—Men and women with metabolic syndrome (29% overall), any of its component features, or higher (greater than upper quartile) insulin resistance (homeostasis model assessment) had more rapid BMI or weight gain than the rest of the cohort throughout infancy, childhood, and adolescence. Glucose intolerance (impaired glucose tolerance or diabetes) was, like metabolic syndrome, associated with rapid BMI gain in childhood and adolescence but with lower BMI in infancy.

CONCLUSIONS—In this Indian population, patterns of infant BMI and weight gain differed for individuals who developed metabolic syndrome (rapid gain) compared with those who developed glucose intolerance (low infant BMI). Rapid BMI gain during childhood and adolescence was a risk factor for both disorders.


  • Published ahead of print at on 3 October 2008.

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    • Accepted August 27, 2008.
    • Received May 16, 2008.
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  1. Diabetes Care vol. 31 no. 12 2349-2356
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