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Physical activity, blood glucose and c-peptide in healthy school-children
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
School of Human Sciences University of Kalmar, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping. (Landstinget i Östergötland; Centre of Paediatrics and Gynecology and Obstetrics in Östergötland; Department of Paediatrics UHL; Barn- och kvinnocentrum; Barn- och ungdomsmedicinska kliniken US)
2010 (English)Article in journal (Refereed) Submitted
Abstract [en]

Background: The incidence of type 1 diabetes is increasing. This increase must be due to environmental factors. Low physical activity and overweight/obesity among children may play a role.

Objective: The aim of the current study was to investigate how lack of physical activity relates to blood glucose value and insulin sensitivity in healthy children. A second aim was to explore whether low physical activity is related to overweight/obesity in children.

Methods: This study is part of the prospective cohort study ‘All Babies In southeast Sweden’ (ABIS). 199 children from different schools participated. Pedometersteps during 4 days were registered as well as height and weight, and fasting blood glucose and serum C-peptide were determined. Parents answered a questionnaire.

Results: Fewer dailysteps correlated to higher BMI (P= 0.019) and waist circumference (P=0.018) as well as to higher C-peptide (P= 0.044), HOMA IR (P=0.046) and HOMA β-cell (P=0.022). Children who spent more hours/day in front of TV/Video had higher waist circumference (P= 0.033) and higher fasting blood glucose values (P=0.016).

Conclusion: Already in early school-age low physical activity is related to increased BMI and waist circumference. These signs and low physical activity are accompanied by a decreased insulin sensitivity compensated for by significantly increased insulin secretion. Low physical activity may cause beta cell stress which might contribute to an autoimmune process in individuals predisposed to autoimmunity, and thereby to the increasing incidence of Type 1 diabetes in children.

Place, publisher, year, edition, pages
2010.
Keyword [en]
Blood glucose, Children, Obesity, Physical activity
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-16606OAI: oai:DiVA.org:liu-16606DiVA: diva2:159022
Available from: 2009-02-06 Created: 2009-02-06 Last updated: 2010-04-20
In thesis
1. Weight gain in children: possible relation to the development of diabetes
Open this publication in new window or tab >>Weight gain in children: possible relation to the development of diabetes
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The prevalence of overweight and obesity among children has increased the last decades and is now defined as a global epidemic disease by the World Health Organization. Also the incidence of type 1 diabetes has increased and there are some hypothesises that argue there is a connection between overweight/obesity and type 1 diabetes.

Aim: The general aim of this thesis was to study factors contributing to the development of overweight and obesity among children and to study possible relations to the development of diabetes.

Method: All Babies in Southeast Sweden, ABIS, is a prospective cohort study. The study includes all babies who were born in southeast Sweden between Oct 1st 1997 until Oct1st 1999 and the design was to follow them up to school age in ABIS I and to follow them until 14 years in ABIS II, of the eligible 74 % entered the study. The families have answered questionnaires and biological samples were taken mainly from the children at the different time points: birth, 1 year, 2.5 years, 5 years and 8-9 years. In this thesis studies have been made including the whole cohort, but some studies have also been made involving only a part of the children.

Results: The prevalence of overweight and obesity among children in the ABIS study was 12.9% overweight and 2.5 % obese at 5 years of age. One risk factor which appeared to have a great impact on the development of overweight and obesity at 5 years of age was the child’s own BMI at an early age and also the heredity for overweight/ obesity and the heredity for type 2 diabetes. If the father had a university degree, the child was less likely to be obese at 5 years of age. Other factors, such as the parents´ age, if the child had any siblings, and if the child lived with a single parent, did not show any significant correlation to the child’s BMI at 5 years of age.

Early nutrition has been studied and no correlation could be found between breastfeeding less than 4 months and the development of overweight/obesity at 5 years of age. The parents answered questions about how frequent the child ate different food at 2.5 years and at 5 years. Intake of sweet lemonade was the only single food which was correlated to a higher BMI in 5 years old children. Porridge seemed to be protective against overweight/ obesity. In one of the studies the physical activity was measured by a step counter. The fewer steps the children were taking, the higher BMI and waist circumference they had. Low physical activity was also associated with a higher C-peptide value and decreased insulin sensitivity. Children who spent more time in front of TV/video had a higher fasting blood glucose value.

Conclusions: A strong factor for the development of overweight and obesity among children is the child’s own BMI at an early age and also its heredity for overweight/ obesity and the heredity for type 2 diabetes. Early nutrition did not show any obvious correlations with overweight and obesity at 5 year old children. Low physical activity was associated with higher fasting C-peptide value and decreased insulin sensitivity. Low physical activity may cause β-cell stress which might contribute to an autoimmune process in individuals genetically predisposed to autoimmunity and, thereby, to the increasing incidence of Type 1 diabetes in children.

Abstract [sv]

Bakgrund: Förekomsten av övervikt och fetma bland barn har ökat under de senaste decennierna och klassas av Världshälsoorganisationen (WHO) som en global epidemi. Antalet barn som insjuknar i typ 1 diabetes har också ökat och det finns en del hypoteser som argumenterar för att det finns en koppling mellan övervikt/fetma och typ 1 diabetes.

Syfte: Den här avhandlingens syfte var att studera faktorer som bidrar till utvecklingen av övervikt och fetma hos barn och att studera om det möjligen finns en relation till utvecklingen av typ 1 diabetes.

Metod: Alla Barn I Sydöstra Sverige, ABIS, är en prospektiv kohort studie. Alla barn, som föddes mellan 1:a oktober 1997 till 1:a oktober 1999 i sydöstra Sverige, erbjöds delta. Barnen följdes sedan upp till skolåldern i ABIS I och till 14 års ålder i ABIS II. Från starten valde 74% av de tillfrågade familjerna att gå med i studien. Familjerna har besvarat frågeformulär, och biologiska prover är tagna huvudsakligen från barnen vid de olika åldrarna: födseln, 1 år, 2.5 år, 5 år och 8-9år. I avhandlingen ingår dels studier med hela ABIS kohorten, men i två av studierna deltar endast en del av barnen.

Resultat: Hos de barn som igår i ABIS studien var 12,9% överviktiga vid 5 års ålder och 2,5% var feta. En faktor som visade sig ha betydelse för utvecklingen av övervikt och fetma hos 5 år gamla barn var barnets eget BMI vid tidig ålder samt hereditet för övervikt/fetma och hereditet för typ 2 diabetes. Om föräldrarna, framförallt pappan, läst på högskola eller universitet var barnen mindre ofta överviktiga/feta. Andra faktorer som föräldrarnas ålder, om barnet hade några syskon och om barnet levde med en ensamstående förälder visade sig inte ha betydelse för utvecklingen av övervikt och fetma hos barnen. Tidig uppfödning har också studerats. Vi fann ingen korrelation mellan kort amning, dvs. mindre än 4 månader, och utvecklingen av övervikt/ fetma hos 5 år gamla barn. Föräldrarna har också fått svara på hur frekvent barnet åt olika livsmedel vid 2.5 år och vid 5 år. Saft var det enda livsmedel som enskilt hade ett samband med utveckling av övervikt och fetma vid 5 år. Gröt föreföll ha en skyddande effekt. I en delstudie har fysisk aktivitet mätts med stegräknare. Ju färre steg ett barn tog, desto större risk förelåg för övervikt och fetma. Låg fysisk aktivitet var också associerad till ett högre C-peptidvärde och minskad insulinkänslighet. Barn som tittar mycket på TV/video hade ett högre fasteblodsocker.

Konklusion: Av betydelse för utveckling av övervikt och fetma hos barn är barnets eget BMI i tidig ålder och dess hereditet för övervikt och fetma samt hereditet för typ 2 diabetes. Tidig nutrition verkar inte ha några uppenbara samband med övervikt och fetma hos 5 år gamla barn. Låg fysisk aktivitet var associerad till högt faste C-peptid och ökad insulinresistens, vilket skulle kunna stressa β-cellerna och därmed, i enlighet med β- cell stress hypotesen, kunna bidra till en ökad förekomst av typ 1 diabetes hos barn.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 49 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1090
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16608 (URN)978-91-7393-729-0 (ISBN)
Public defence
2009-02-13, Qulturum, Länsjukhuset Ryhov, Jönköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-02-06 Created: 2009-02-06 Last updated: 2009-08-21Bibliographically approved

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