Doctors at the All India Institute of Medical Sciences have found a way to nail the propensity of a child to develop heart disease and diabetes — regular insulin monitoring.
After a study involving students of educational institutions in South and West Delhi, the doctors found that in Indian children, high insulin tolerance is the only indicator for a cluster of risk factors —— known as Metabolic Syndrome or Syndrome X. The doctors say the study reveals the need for redefining the syndrome as the criteria differs with that followed in the US.
The study —— just one of four published in the world on childhood syndrome X —— has appeared in Atherosclerosis, a reputed international journal for diabetes and heart disease.
‘‘Impairment of insulin action during childhood is the first step towards diabetes and heart disease. This is called insulin resistance, and it leads to increase in blood glucose and triglycerides, low levels of good cholesterol (HDL), hypertension and increased risk of clot formation in the arteries —— a clustering of risk factors termed as Syndrome X’,’’ said Dr Anoop Misra, the principal investigator of the study and Professor of Medicine at AIIMS.
He and Dr N.K.Vikram based their research on a sample of 1,900 students between the ages of 14 and 18 from schools and colleges in South and West Delhi.
The data, collected between 2000 and 2003, showed that 22 per cent of males and 36 per cent females have insulin resistance, a very high figure and comparable to data for their counterparts in the US.
‘‘When we applied the original definitions for Syndrome X given by the US National Cholesterol Education Programme — abdominal obesity, hypertension, impaired glucose tolerance, high trigylcerides and low level of HDL or good cholesterol — only six children qualified. It was only when we included the Body Mass index (body fat) and testing serum insulin (for insulin resistance) that we got results,’’ said Dr Misra,
‘‘For prevention of diabetes and heart disease in adults, Syndrome X should be vigorously tackled in childhood but for that, it needs to be redefined. Currently no satisfactory definition for identification of Syndrome X in children and adolescents is available. A modified version of NCEP definition of the Syndrome X (for adults) has been used in US adolescents,’’ said Dr Misra.
He said it is important to characterise and prevent Metabolic Syndrome in Asian Indians at a young age, since this ethnic group is highly predisposed to insulin resistance, diabetes and coronary heart disease.
‘‘Vigorous lifestyle measures, more exercises and some nutritional or dietary changes can help prevent obesity in these children, which can in turn help prevent these diseases,’’ he said.