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Table 4 Phenotypic outcomes in the children in both cohorts

From: Protocol for the EMPHASIS study; epigenetic mechanisms linking maternal pre-conceptional nutrition and children’s health in India and Sub-Saharan Africa

Domain

Primary outcomes

Secondary outcomes

Birth outcomes

Measured:

Measured:

Birth weight (g)

Birth length (cm)

Head, chest, abdomen and mid-upper arm circumferences (cm)

Triceps and subscapular skinfolds (mm)

Derived:

Small for gestational age (SGA, N [%])a

Derived:

Gestational age (weeks)

Low birth weight (<2500 g) (N [%])

Pre-term (<37 completed weeks’ gestation) N [%])

At follow-up in childhood

 Anthropometry

Measured:

Measured:

Standing height (cm)

Weight (kg)

Sitting height (cm)

Head, chest, waist, hip and mid-upper arm circumferences (cm)

Biceps, triceps, subscapular, supra-iliac skinfolds (mm)

Derived:

Derived:

Body mass index (BMI) (kg/m2)

Weight-, height- and BMI-for-age Z-scoresb (SD)

Stunted, wasted, underweightb (N [%])

Leg length (cm)

Sitting height/leg length ratio

Head circumference-for-age Z-scoreb (SD)

Sum of skinfolds (mm)

Waist/hip ratio

Longitudinal growth measures

 Body composition (DXA)

Measured:

Measured:

 

Total lean mass (kg)

Total fat mass (kg)

Android fat (kg)

Gynoid fat (kg)

 

Derived:

Lean mass index (kg/m2)

Fat mass index (kg/m2)

Derived:

Body fat %

 Bone (DXA and pQCT)

Measured:

Measured:

 

DXA:

Total and spine bone area (BA) (cm2)

Total and spine bone mineral content (BMC) (g)

Derived:

DXA:

Spine bone mineral apparent density (BMAD; (g/cm3)

DXA:

Total and spine bone mineral density (BMD) (g/cm2)

pQCT (Gambia only):

Metaphyseal (8%) and diaphyseal (50%) tibia. Measurements taken using voxel size 0.5 mm, slice thickness 2 mm.

Tibial total and trabecular BA (mm2) and volumetric BMD (vBMD) (mg/mm3).

Diaphysial BA (mm2), BMC (mg/mm), vBMD (mg/mm3), cortical area (mm2) and thickness (mm), and strength (cross-sectional moment of inertia) (mm4).

 Cardio-metabolic risk markers

Measured:

Measured:

Systolic blood pressure (mmHg)

Fasting glucose (mmol/l)

30- &120-min glucose (mmol/l)

LDL-cholesterol (mmol/l)

HDL-cholesterol (mmol/l)

Triglycerides (mmol/l)

Diastolic blood pressure (mmHg)

Fasting insulin (pmol/l)

30-min insulin (pmol/l)

Derived:

Derived:

Insulin resistance (HOMA-IR)c

Disposition indexd

High blood pressure (mmHg)e

Insulinogenic indexf

Metabolic syndrome N [%])g

 Cognitive function

Measured:

 
 

Scores from Atlantis, Pattern reasoning, Kohs block design, Word order, Verbal fluency and Coding tests

 

Derived:

 

Mental processing indexh (SD)

 
  1. Legend: a SGA defined as below the 10th percentile for birth weight for gestational age using INTERGROWTH data [51]
  2. b according to WHO/CDC growth reference: http://www.who.int/growthref/en/
  3. c Insulin resistance according to Homeostasis Model Assessment: https://www.dtu.ox.ac.uk/homacalculator/
  4. d Disposition index: an estimate of insulin secretion taking into account insulin resistance, to be calculated as insulinogenic index/HOMA-IR [52]
  5. e High blood pressure defined as >99th percentile according to an international reference: https://www.nhlbi.nih.gov/health-pro/guidelines/current/hypertension-pediatric-jnc-4/blood-pressure-tables
  6. f Insulinogenic index: an estimate of first-phase insulin secretion, calculated as (insulin at 30 min – fasting insulin)/(glucose at 30 min – fasting glucose) [53]
  7. g Metabolic Syndrome: There is no accepted definition of metabolic syndrome in children of this age; a binary variable will be created, where 1 represents children who are above the highest sex-specific within-cohort quartiles for android fat on DXA, systolic blood pressure, plasma triglyceride concentration and HOMA-IR, and below the lower quartile for HDL-cholesterol
  8. h a composite score of cognitive function, calculated as the mean of the standardised scores from the 6 individual cognitive tests
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BMC Nutrition

ISSN: 2055-0928

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