Jefferis, BJMH; (2007) How do childhood cognition and life course health behaviours affect adult glucose homeostasis? Doctoral thesis , UCL (University College London).

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Abstract

AIM: To examine pathways from childhood cognitive ability, through adolescent and adult health behaviours to midlife glucose homeostasis.;SETTING: Prospective, population-based 1958 British birth cohort with information about cognitive trajectories between 7 and 16 years, tobacco and alcohol use up to the forties, adult social position and educational qualifications and 45-year glucose homeostasis (indexed by HbAic level, elevated HbAic / type 2 diabetes status and metabolic syndrome).;RESULTS: Poorer 7-year ability was associated with non-drinking, binge drinking and smoking in adulthood. Smoking was associated with poorer glucose homeostasis, with evidence of dose-response effects. There were graded associations between drinking frequency and glucose homeostasis infrequent and non-drinkers had higher HbAic and greater risks of metabolic syndrome than more frequent drinkers. Poorer 7-year ability (rather than change in ability 7-16 years) was associated with poorer glucose homeostasis. These associations were mediated by lifecourse smoking and drinking frequency. Additionally adult social class and qualifications were important mediators of the associations. Adult adiposity was a strong mediator between cognition and glucose regulation and, when explored as an outcome, there were inverse associations between 7-year ability and 45-year BMI or waist circumference, and smoking and drinking trajectories were associated with adult adiposity. Adult smoking and drinking were associated with glucose regulation after adjustment for confounding factors smoking and less frequent alcohol use were associated with poorer metabolic control.;CONCLUSIONS: Poorer childhood cognitive development was modestly associated with poorer mid-adult glucose homeostasis. These associations were not due to confounding by early life factors, but were largely mediated by adult smoking and drinking and adult socio economic position. The same pathways similarly influenced adult adiposity which was an important mediator between cognitive ability and adult glucose regulation. Smoking and drinking into adult life are shaped by childhood cognition and both in turn shape adult glucose regulation.

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