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Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults.
J Nutr 2016; 146(11):2289-2295JN

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.

Authors+Show Affiliations

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.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.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.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.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.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.Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China; and.Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China; and.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.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.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.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.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.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.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.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.Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China; and.Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA.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.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.

Pub Type(s)

Historical Article
Journal Article

Language

eng

PubMed ID

27629572

Citation

Wang, Jing, et al. "Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults." The Journal of Nutrition, vol. 146, no. 11, 2016, pp. 2289-2295.
Wang J, Li Y, Han X, et al. Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults. J Nutr. 2016;146(11):2289-2295.
Wang, J., Li, Y., Han, X., Liu, B., Hu, H., Wang, F., ... He, M. (2016). Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults. The Journal of Nutrition, 146(11), pp. 2289-2295.
Wang J, et al. Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults. J Nutr. 2016;146(11):2289-2295. PubMed PMID: 27629572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exposure to the Chinese Famine in Childhood Increases Type 2 Diabetes Risk in Adults. AU - Wang,Jing, AU - Li,Yaru, AU - Han,Xu, AU - Liu,Bing, AU - Hu,Hua, AU - Wang,Fei, AU - Li,Xiulou, AU - Yang,Kun, AU - Yuan,Jing, AU - Yao,Ping, AU - Miao,Xiaoping, AU - Wei,Sheng, AU - Wang,Youjie, AU - Liang,Yuan, AU - Zhang,Xiaomin, AU - Guo,Huan, AU - Yang,Handong, AU - Hu,Frank B, AU - Wu,Tangchun, AU - He,Meian, Y1 - 2016/09/14/ PY - 2016/04/19/received PY - 2016/08/18/accepted PY - 2016/11/3/pubmed PY - 2017/6/3/medline PY - 2016/9/16/entrez KW - China KW - childhood KW - famine KW - fetal KW - type 2 diabetes SP - 2289 EP - 2295 JF - The Journal of nutrition JO - J. Nutr. VL - 146 IS - 11 N2 - 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. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/27629572/Exposure_to_the_Chinese_Famine_in_Childhood_Increases_Type_2_Diabetes_Risk_in_Adults_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.116.234575 DB - PRIME DP - Unbound Medicine ER -