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Twins in Guinea-Bissau have a ‘thin-fat’ body composition compared to singletons

Published online by Cambridge University Press:  04 April 2022

Rucha Wagh ,
Morten Bjerregaard-Andersen ,
Souvik Bandyopadhyay ,
Pranav Yajnik ,
Rashmi B. Prasad ,
Suhas Otiv ,
Stine Byberg ,
Ditte Egegaard Hennild ,
Gabriel Marciano Gomes  and
Kaare Christensen
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Rucha Wagh
Affiliation:
Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, Maharashtra, India
Morten Bjerregaard-Andersen*
Affiliation:
2Bandim Health Project, INDEPTH Network, Bissau Codex, Guinea-Bissau Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
Souvik Bandyopadhyay
Affiliation:
Strategic Consultant, Cytel, Inc., Bangalore, India
Pranav Yajnik
Affiliation:
Cytel, Inc., Cambridge, MA, USA
Rashmi B. Prasad
Affiliation:
Lund University Diabetes Centre, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
Suhas Otiv
Affiliation:
Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, Maharashtra, India
Stine Byberg
Affiliation:
2Bandim Health Project, INDEPTH Network, Bissau Codex, Guinea-Bissau Steno Diabetes Center Copenhagen, Gentofte, Denmark
Ditte Egegaard Hennild
Affiliation:
2Bandim Health Project, INDEPTH Network, Bissau Codex, Guinea-Bissau
Gabriel Marciano Gomes
Affiliation:
2Bandim Health Project, INDEPTH Network, Bissau Codex, Guinea-Bissau
Kaare Christensen
Affiliation:
The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark Department of Clinical Genetics, Odense University Hospital, Odense, Denmark Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
Morten Sodemann
Affiliation:
2Bandim Health Project, INDEPTH Network, Bissau Codex, Guinea-Bissau Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
Dorte Møller Jensen
Affiliation:
Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
Chittaranjan S. Yajnik*
Affiliation:
Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, Maharashtra, India
*
Address for correspondence: Morten Bjerregaard-Andersen, Department of Endocrinology, Hospital of Southwest Jutland, Haraldsgade 7, 6700, Esbjerg, Denmark. E-mail: Morten.Bjerregaard-Andersen2@rsyd.dk; Chittaranjan S. Yajnik, Diabetes Unit, KEM Hospital Research Centre, Pune, India, Email: csyajnik@gmail.com
Address for correspondence: Morten Bjerregaard-Andersen, Department of Endocrinology, Hospital of Southwest Jutland, Haraldsgade 7, 6700, Esbjerg, Denmark. E-mail: Morten.Bjerregaard-Andersen2@rsyd.dk; Chittaranjan S. Yajnik, Diabetes Unit, KEM Hospital Research Centre, Pune, India, Email: csyajnik@gmail.com
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Abstract

The ‘thrifty phenotype’ hypothesis proposed that fetal undernutrition increases risk of diabetes in later life. Undernourished low birthweight Indian babies are paradoxically more adipose compared to well-nourished European babies, and are at higher risk of diabetes in later life. Twin pregnancies are an example of in utero growth restrictive environment due to shared maternal nutrition. There are few studies of body composition in twins. We performed secondary analysis of anthropometric body composition of twins and singletons in Guinea-Bissau, an economically deprived African country.

Anthropometric data were available on 7–34 year-old twins (n = 209, 97 males) and singletons (n = 182, 86 males) in the Guinea-Bissau Twin Registry at the Bandim Health Project. Twins had lower birthweight (2420 vs 3100 g, p < 0.001); and at follow-up, lower height (HAZ mean Z-score difference, −0.21, p = 0.055), weight (WAZ −0.73, p = 0.024) and BMI (BAZ −0.22, p = 0.079) compared to singletons but higher adiposity (skinfolds: +0.33 SD, p = 0.001). Twins also had higher fasting (+0.38 SD, p < 0.001) and 2-hour OGTT glucose concentrations (+0.29 SD, p < 0.05). Linear mixed-effect model accounting for intrapair correlations and interactions confirmed that twins were thinner but fatter across the age range. Data on maternal morbidity and prematurity were not available in this cohort.

African populations are known to have a muscular (less adipose) body composition. Demonstration of a thin-fat phenotype in twins in a low socio-economic African country supports the thesis that it could be a manifestation of early life undernutrition and not exclusive to Indians. This phenotype could increase risk of diabetes and related conditions.

Keywords

Twinsadipositythin-fatearly life undernutritionGuinea-Bissau
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 13 , Issue 6 , December 2022 , pp. 787 - 793
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Copyright
© The Author(s), 2022. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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