South Asian (SA), British-born adults have increased cardiovascular (CV) risk factors compared to White Europeans (WE). Early detection of CV risk may allow intervention. The Manchester HAPO (Hyperglycaemia and Adverse Pregnancy Outcomes) cohort showed babies of SA origin were born significantly shorter, lighter and had a lower mean BMI SDS than those of WE origin. We now report ethnic differences in body composition and CV markers in childhood. Measurements on 102 children (56 WE, (25F:31M); 46 SA, (22F:24M), mean age 8.9, range 612 y) included; height, weight, body fat % (truncal fat for central and arm fat for peripheral adiposity), skinfold thicknesses and Doppler echocardiography. Maternal data in pregnancy on BMI, glucose tolerance and blood pressure were available. Differences in height, weight and BMI seen at birth were no longer significant. Despite comparable BMIs (19.6 vs 18.7 kg/m2; P=0.3), SA children had significantly higher mean whole body fat (28.4% vs 23.3%; P=0.001), central fat (6.9% vs 4.6%; P=0.001), peripheral fat (7.2% vs 4.9%; P=0.001) and supra-iliac skinfolds (15.3 vs 10.3 mm; P=0.002) than WE children. Maternal BMI correlated with the childs BMI SDS (0.24; P=0.02), whole body fat (0.30; P=0.01), central fat (0.28; P=0.02), peripheral fat (0.24; P=0.04) and supra-iliac skinfolds (0.32; P=0.002). Diastolic function also displayed ethnic differences, with late phase LV filling (A wave) being elevated (56.2 vs 48.4 cm/s; P=0.005) and E/A ratio lower (1.74 vs 2.09; P=0.001) in SA versus WE children. Differences were unrelated to maternal BMI, glucose tolerance or blood pressure. Generalised linear modelling was used to identify the contribution of ethnicity, gender, current height SDS, weight SDS (or BMI SDS), BMI SDS at birth and maternal BMI SDS to the E/A ratio or to central adiposity. Only ethnicity was significantly associated with E/A ratio (P=0.003) whilst ethnicity, height SDS and weight SDS were associated with central adiposity (all P<0.001). In this cohort: 1) SA children had higher levels of central and peripheral adiposity than their WE counterparts despite comparable BMIs, 2) SA children had lower E/A ratios suggesting poorer diastolic function and 3) maternal BMI in pregnancy correlated with their childs body composition at age 8y. We conclude that ethnicity influences body composition and cardiovascular function and that maternal BMI in pregnancy has a lasting impact on offspring body composition.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology