Prof Santosh Bhargava, Pediatrician, Department of Pediatrics, Sunder Lal Jain Hospital, Delhi

Prof HPS Sachdev, Professor and in-charge, Division of Clinical Epidemiology, Department of Pediatrics, Maulana Azad Medical College, New Delhi

Dr Caroline Fall, designation as elsewhere

Prof KS Reddy, Department of Cardiology, All India Institute of Medical Sciences, New Delhi

Dr Clive Osmond, Statistician, MRC Environmental Epidemiology Unit, University of Southampton, UK.

Dr Ramakrishnan Lakshmy Biochemist, Department of Cardiology, All India Institute of Medical Sciences, New Delhi

Prof David JP Barker Emeritus Professor, Former Director of the MRC Environmental Epidemiology Unit, University of Southampton, UK

Mr Sushant K Dey Biswas Indian Council of Medical Research, New Delhi

Prof Siddharth Ramji Paediatrician, Department of Pediatrics, Maulana Azad Medical College, New Delhi

Dr Dorairaj Prabhakaran, Cardiologist, Department of Cardiology, All India Institute of Medical Sciences, New Delhi

 

Cardiovascular risk factors in young Indian adults 

The New Delhi birth cohort was established in 1969-1972 by Dr Shanti Ghosh and Dr Santosh Bhargava, funded by the National Centre for Health Statistics, USA and the Indian Council of Medical Research. All families living in a 12 km2 area of South Delhi were identified and 20,755 married women of reproductive age were followed up bi-monthly to record menstrual dates. There were 9,169 pregnancies, resulting in 8,181 live births. Trained personnel recorded the weight and length/height of the babies at birth and 6 monthly until the age of 21 years. This has created a unique dataset in which size and body proportions are available at birth and continuously throughout childhood for a large number of individuals who are now young adults. They grew up during a period of rapid social and economic change in India.

In a follow up study of the cohort in 1998-2003, 2,584 of the original subjects were re-traced, now aged 29 years, living in or near Delhi. 1,526 agreed to take part in a new project. The aim was to measure a range of factors related to risk for cardiovascular disease and type 2 diabetes and link these to the pattern of growth in early life. Data on the subjects lifestyle were recorded, and body composition was measured anthropometrically. An ECG was performed and blood samples were taken for plasma glucose, insulin and lipid concentrations, and an oral glucose tolerance test was carried out.

Main findings:

  1. Even at this young age there was a high prevalence of impaired glucose tolerance (11%) and type 2 diabetes (4%).
  2. The pattern of growth associated with a higher risk of abnormal glucose tolerance in adult life was characterized by low weight at birth, low weight and thinness in infancy, an early adiposity rebound, and accelerated gain in weight and body mass index from the age of 2 years onwards.
  3. It was concluded that interventions to prevent diabetes in India should start in early childhood, protecting infant growth and preventing children from crossing increasing centiles of body mass index after the age of 2 years.

Publications: 

Bhargava SK, Sachdev HPS, Fall CHD, Osmond C, Lakshmy R, Barker DJP, Dey Biswas SK, Ramji S, Prabharkaran D, Reddy KS. Relation of serial changes in childhood body mass index to impaired glucose tolerance in young adulthood. New England J Med  2004;350:865-75.

Funding:

This study is funded by the British Heart Foundation and the Medical Research Council, UK.