Format

Send to

Choose Destination
J Nutr. 2016 Nov;146(11):2289-2295. Epub 2016 Sep 14.

Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults.

Author information

1
Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
2
Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China; and.
3
Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA.
4
Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; hemeian@hotmail.com.

Abstract

BACKGROUND:

Evidence shows that exposure to poor conditions in early life is associated with an increased risk of chronic diseases in adults.

OBJECTIVE:

We investigated whether exposure to the Chinese famine (1959-1961) in the fetal stage or in childhood (0-9 y) was associated with type 2 diabetes (T2D) and hyperglycemia in adulthood.

METHODS:

We included 7801 subjects aged 56.4 ± 3.3 y from the Dongfeng-Tongji cohort. Subjects were classified into late-, middle-, and early-childhood-exposed, fetal-exposed, and unexposed groups. Excess mortality rate was used to evaluate the severity of famine. Logistic regression models were used to analyze the famine-dysglycemia associations. Generalized linear models were used to assess the famine effects on dysglycemia risk during the 5-y follow-up period among 3100 subjects.

RESULTS:

In descriptive analyses, the risk of T2D was significantly greater in the middle-childhood-exposed group (OR: 1.44; 95% CI: 1.10, 1.87; P = 0.007), and the risk of hyperglycemia was higher in the middle- and late-childhood-exposed groups than in the unexposed group (OR: 1.54; 95% CI: 1.26, 1.88 and OR: 1.51; 95% CI: 1.23, 1.85, respectively). In sex-specific analyses, women exposed in middle childhood (OR: 1.55; 95% CI: 1.16, 2.06) and late childhood (OR: 1.40; 95% CI: 1.05, 1.87) had a higher risk of T2D than unexposed women. This association was not found in men. Similar associations were found for hyperglycemia risk. Moreover, subjects who experienced severe famine in childhood had a 38% higher T2D risk (95% CI: 1.05, 1.81) than those exposed to less severe famine. In retrospective cohort analyses, participants who experienced famine in middle childhood had a higher hyperglycemia risk relative to the unexposed group (RR: 2.06; 95% CI: 1.08, 3.90).

CONCLUSION:

Exposure to the Chinese famine in childhood was related to an increased risk of adulthood T2D and hyperglycemia, particularly in women.

KEYWORDS:

China; childhood; famine; fetal;  type 2 diabetes

PMID:
27629572
DOI:
10.3945/jn.116.234575
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center