16 intrauterine programming of ncd 24 olson memori... - DSM

SIGHT AND LIFE | VOL. 25 (2) | 2011 INTRAUTERINE PROGRAMMING OF NCD 1919paternal size predominantly influenced skeletal measurements,while the baby’s adiposity was predominantly determined bymaternal factors. Short and fat mothers gave birth to the mostadipose babies, suggesting an intergenerational influence ofmaternal early life “growth retardation” and the mother’s subsequentweight gain on body composition of the growing fetus. 17One more interesting finding was that babies born to multiparouswomen had higher skin folds and a higher abdominal circumferencethan those born to primiparous women. 19“A gain in maternal tissue during earlyweeks is an important determinant offetal growth”Maternal weight gain during the first 18 weeks influenced allneo-natal measurements, indicating that a gain in maternaltissue during early weeks is an important determinant of fetalgrowth. Placental volume measurement at 18 weeks’ gestationwas also an independent determinant of fetal growth, highlightingthe role for this important organ. 20The “thin-fat” Indian babyWe compared the birth measurements of Indian babies withthose of white Caucasian babies born in Southampton, UK. Indianbabies were lighter (2.7 vs. 3.5 kg, z score -1.74), shorter (47.3vs. 50.2 cm, z score -1.01) and thinner (PI 24.5 vs. 28.2 kg/cm³,z score -1.62), but their sub-scapular skin fold measurementswere relatively well preserved (4.2 vs. 4.6 mm, z score -0.53). Atany sub-scapular skin fold thickness, Indian babies had a lowerPI than that of the white Caucasian babies. 21In a subsequent study, we used whole body MRI to calculatebody fat and its regional distribution in neonates. Compared tothe larger white Caucasian babies, the Indian babies had similarwhole body adipose tissue content (“thin-fat”) and significantlyhigher absolute adiposity in all three abdominal compartments,viz internal (visceral), deep subcutaneous and superficial subcutaneous.Non-abdominal superficial subcutaneous adipose tissuewas, however, lower. 22 Thus, Indian babies are more adiposeand have a fat distribution that is suggestive of a higher risk ofdiabetes, as compared to white Caucasian babies.(Figures 1 and 2)figure 2: Thin-Fat Indian Baby. Anthropometry and MRI comparison of Indian and white Caucasian babies. Despite their anthropometricsmallness, Indian babies had a higher amount of fat in subcutaneous and visceral abdominal compartments. White Caucasian babiesare used as reference, and z scores for Indian babies are plotted. 22 This figure is not to scale. The figure highlights relative adiposity ofIndian newborns.3.002.00Mean z score (95% CI)1.000.00–1.00–2.00Anthropometry Abdominal Non-AbdominalWeightHead circumferenceLengthInternal-abdominalDeep subcutaneous abdominalSuperficial subcutaneous abdominalInternal non-abdominalDeep subcutaneous non-abdominalSuperficial subcutaneous non-abdominalTotal adipose tissue