The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study

Abstract

BackgroundThe associations of famine exposure with diabetes risk in adulthood are still unclear. This study aimed to explore the association between famine exposure in early life and risk of diabetes in adulthood.MethodsA total of 4138 subjects were selected from the data of the China Health and Retirement Longitudinal Study (CHARLS) 2011–2012. Diabetes was diagnosed as fasting plasma glucose (FPG) ≥7.0 mmol/L, glycated haemoglobin (HbA1C) > 6.5%, or self-reported diabetes. Birthdates of subjects were used to categorize famine exposure groups. The association of fetal-stage famine exposure with diabetes risk in adults was assessed using logistics regression model.ResultsThe prevalence of diabetes in the non-exposed, fetal-stage exposed, infant-stage exposed, and preschool-stage exposed groups were 9.0, 13.6, 12.7 and 10.8%, respectively. Compared with the age-balanced control group, the fetal-stage exposed group was associated with the elevated risk of diabetes in later life after adjusting for covariates (OR = 1.37; 95%CI: 1.09–1.72; P = 0.008). Stratified analysis showed that the association between prenatal famine exposure and diabetes risk in adulthood was comparable between severely affected areas and less severely affected areas (P for interaction =0.153).ConclusionsFamine exposure in fetal stages was associated with the elevated diabetes risk in adults, which could be the critical periods for relative intervention.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6134-x) contains supplementary material, which is available to authorized users.

Early-life exposure to the Chinese famine of 1959–61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study

“…Consistent with some studies [20,23,39], we did not find any larger famine effects among adults born in severely affected versus less severely affected areas. This result may be explained by a great variation of famine severity in the county-level mortality [19], which caused the misclassification of famine severity.…”

“…The severity of Chinese famine varied remarkably across regions and time [19]. As shown in previous studies [20][21][22][23], provincial excess mortality in 1956-62 was computed as an indicator of famine severity, and excess mortality of 50% was used to classify provinces into severely affected and less severely affected areas.…”

Foetal and childhood exposure to famine and the risks of cardiometabolic conditions in adulthood: A systematic review and meta‐analysis of observational studies

“…Of these 71 articles, 24 were further excluded for various reasons (Appendix S1). Finally, 47 articles were included in the present meta‐analysis. The articles were published between 2006 and 2019, mostly published from 2014 onwards.…”

“…Foetal exposure to famine was associated with higher risks of T2DM (RR 1.37, 95% CI, 1.23‐1.52; Figure ), metabolic syndrome (RR 1.26, 95% CI, 1.07‐1.50; Figure ), hypertension (RR 1.30, 95% CI, 1.07‐1.57; Figure ), hyperglycaemia (RR 1.27, 95% CI, 1.11‐1.45; Figure ), dyslipidaemia (RR 1.48, 95% CI, 1.33‐1.66; Figure 2), obesity (RR 1.19, 95% CI, 1.02‐1.39; Figure ), overweight (RR 1.17, 95% CI, 1.07‐1.29; Figure ), coronary heart disease (RR 1.22, 95% CI, 1.00‐1.51; Figure ), and moderate‐to‐severe NAFLD (RR 1.66, 95% CI, 1.07‐2.57; Figure 3) . No association was observed for the risks of stroke (RR 1.21, 95% CI, 0.96‐1.52; Figure ) or mild NAFLD (RR 1.04, 95% CI, 0.64‐1.70; Figure 3) .…”

Ten SNPs May Affect Type 2 Diabetes Risk in Interaction with Prenatal Exposure to Chinese Famine

“…Some studies found that exposure to severe famine in the prenatal or postnatal period was associated with the development of type 2 diabetes in adulthood. Data from different periods of famine around the world have been utilized to explore the association of early life malnutrition and type 2 diabetes risk in adulthood, and the “famine effect” has been found in China and some foreign studies, including Asian, European, and African populations [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”