Overview
The Vellore Birth Cohort (VBC) is led by Dr Belavendra Antonisamy, Christian Medical College, Vellore (Insert Image 8). Other key investigators are Dr Nihal Thomas, Dr Viji Samuel, and Dr Geethanjali, Christian Medical College, Vellore. Key collaborators are Dr Fredrik Karpe, Oxford Centre for Endocrinology, Diabetes and metabolism, and Dr Senthil Vasan, MRC LEC. The cohort was set up prospectively in 1969 in order to study rates of low birth weight and pre-term birth and infant mortality and was a ‘twin’ cohort in South India to the New Delhi Birth Cohort. The babies were followed up throughout childhood and adolescence with measurements of height and weight in infancy (1-3 months), childhood (6-8 years) and adolescence (10-15 years). The first study in adult life, in 1998-2002 at the age of ~30 years, looked at the relationship between childhood growth and adult cardiometabolic risk markers. The cohort is now aged ~50 years and is currently involved in a study of cardiac structure and function, measured using echocardiography (the “INDECHO” study).
Objectives
The objective of the original cohort study was to describe birth weight and pre-term birth patterns and infant mortality. The collaboration between the MRC LEC and the VBC started in 1995, and the cohort was re-traced to study the relationship of birth weight and patterns of post-natal growth with the later development of type 2 diabetes, hypertension, other cardiovascular risk markers, in order to identify interventions and interventional windows in childhood to prevent later cardiovascular disease and diabetes. Further rounds of follow-up have repeated these risk markers, and have also examined other cardiovascular and NCD outcomes.
Methods
In 1998-2002, at a mean age of 29 years and in 2013-2014 (mean age 42 years) data were collected on socio-economic status, lifestyle, anthropometry, blood pressure, glucose tolerance, fasting insulin and lipids. In the last three years, in a parallel study with the New Delhi Birth Cohort data have been collected on left ventricular structure and function, and carotid intima media thickness (cIMT), using echocardiography (the “INDECHO” study). Body composition, glucose tolerance and serum lipids have also been re-measured.
Findings from the Vellore Birth Cohort study:
- Faster BMI gain during childhood and adolescence was associated with higher adult cardiometabolic risk markers
- The prevalence of cardiometabolic risk markers in this mixed urban and rural cohort was very high. Between 29 and 42 years, the prevalence of overweight/obesity increased from 17% to 51%; that of type 2 diabetes from 3% to 16%; that of hypertension from 2% to 20% and that of hypertriglyceridaemia from 16% to 30%. Although the prevalence was higher among urban participants at both ages, the increase was greater among rural participants
Selected recent publications from the Vellore Birth Cohort:
- Antonisamy B, Vasan SK, Geethanjali FS, Gowri S, Hepsy FS, Richard J, Raghupathy P, Karpe F, Osmond C, Fall CHD. Weight gain and height growth during infancy, childhood, and adolescence as predictors of adult cardiovascular risk. J Pediatr 2017; 180: 53-61. PMID: 27823768
- Vasan SK, Roy A, Samuel VT, Antonisamy B, Bhargava SK, Alex AG, Singh B, Osmond C, Geethanjali FS, Karpe F, Sachdev HPS, Agrawal K, Ramakrishnan L, Tandon N, Thomas NJ, Premkumar PS, Asaithambi P, Princy SFX, Sinha S, Paul TV, Prabhakaran D, Fall CHD. IndEcho study: Cohort study investigating birth size, childhood growth and young adult cardiovascular risk factors as predictors of mid-life myocardial structure and function in South Asians. BMJ Open 2018:8:e019675. doi:10.1136/bmjopen-2017-019675. PMID: 29643156