Background/aims: The concept of the 'thin-fat' Indian baby is well established, but there is little comparative data in older children, and none that examines the metabolic correlates. Accordingly, we investigated the impact of body composition on the metabolic profiles of Asian Indian and white U.K. children.
Methods: Body mass index (BMI), waist circumference, sum of four skin-folds, % body fat (by dual-energy X-ray absorptiometry), glucose, insulin, insulin resistance (Homeostasis Model Assessment), trigylcerides, cholesterol [total, low-density lipoprotein, high-density lipoprotein {HDL}, total/HDL ratio] and blood pressure (systolic, diastolic and mean arterial) were measured in 262 white Caucasian children from Plymouth, U.K. (aged 6.9 ± 0.2 years, 57% male), and 626 Indian children from rural villages around Pune, India (aged 6.2 ± 0.1 years, 53% male).
Results: Indian children had a significantly lower BMI (boys: -2.1 kg m(-2) , girls: -3.2 kg m(-2) , both P < 0.001), waist circumference (P < 0.001) and skin-fold thickness (P < 0.001) than white U.K. children, yet their % body fat was higher (boys +4.5%, P < 0.001, girls: +0.5%, P = 0.61). Independently of the differences in age and % body fat, the Indian children had higher fasting glucose (boys +0.52 mmol L(-1) , girls +0.39 mmol L(-1) , both P < 0.001), higher insulin (boys +1.69, girls +1.87 mU L(-1) , both P < 0.01) and were more insulin resistant (boys +0.25, girls +0.28 HOMA-IR units, both P < 0.001).
Conclusions: The 'thin-fat' phenotype observed in Indian babies is also apparent in pre-pubertal Indian children who have greater adiposity than white U.K. children despite significantly lower BMIs. Indian children are more insulin resistant than white U.K. children, even after adjustment for adiposity.
© 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.