Understanding gender differences in cardiometabolic risk across the life course

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Heart disease and diabetes are leading causes of death in men and women globally and in the UK. Gender differences in diabetes exist in adults. For example, diabetes is more common in men than in women. On average, overweight or obese men also develop diabetes at a lower level of fatness than overweight or obese women. However, once a woman becomes diabetic she is much more likely to develop heart disease than a diabetic man. We know that a person's risk of diabetes and heart disease begins to take shape in childhood. Even in young children the level of sugar and other substances in the blood can tell us about the risk of them developing diabetes as adults. The aim of this project is to find out if differences between men and women in terms of their diabetes and heart disease risk later in life are already evident in young boys and girls from birth all the way through childhood and into early adulthood. I will do this by comparing the amount of sugar and other substances in the blood of boys and girls from when they are born to when they are young adults. I will investigate if young boys who are overweight or obese have the same levels of sugar in their blood as young girls who are overweight or obese. This will tell us if overweight or obese boys already show a higher chance of getting diabetes compared to overweight or obese girls. I will also investigate if girls with high levels of sugar and other substances in their blood have problems with their hearts compared to boys with high level of sugars and other substances in their blood. This will tell us if the higher level of heart disease in diabetic women later in life is already detectable in the hearts of young girls with high levels of sugar and other substances in their blood, that are linked to diabetes. I will then investigate the reasons behind any differences; whether different behaviour patterns such as smoking or physical activity, biological factors such as hormones or differences in body shape which reflect different patterns of fat storage explain the differences. I will use data from two different studies that followed participants from birth across childhood into adulthood. The Avon Longitudinal Study of Parents and Children started with over 14,000 pregnant women in Bristol in 1991/1992 and their children have been followed ever since, now aged 25. The Andhra Pradesh Children and Parents Study started with over 2,500 children born in India between 1987 and 1990 and has followed them up three times up to the age of 25. I will examine each study separately and then compare the findings to see if they are alike or different. This will help me to find out if my findings are consistent in these two very different populations. By identifying when in life the gender differences we see in older adults actually start, we can identify times when programs to prevent them might be effective. By identifying the reasons behind any gender differences, effective gender-specific programs and interventions can be delivered early in life to prevent gender differences later in life.