Exposure to the Chinese famine in early life and the risk of hyperglycemia and type 2 diabetes in adulthood.

Y. Li, Y. He, L. Qi, V.W. Jaddoe, E.J.M. Feskens, X. Yang, G. Ma, F.B. Hu

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243 Citations (Scopus)

Abstract

OBJECTIVE Early developmental adaptations in response to undernutrition may play an essential role in susceptibility to type 2 diabetes, particularly for those experiencing a "mismatched rich nutritional environment" in later life. We examined the associations of exposure to the Chinese famine (1959-1961) during fetal life and childhood with the risk of hyperglycemia and type 2 diabetes in adulthood. RESEARCH DESIGN AND METHODS We used the data for 7,874 rural adults born between 1954 and 1964 in selected communities from the cross-sectional 2002 China National Nutrition and Health Survey. Hyperglycemia was defined as fasting plasma glucose >= 6.1 mmol/1 and/or 2-h plasma glucose >= mmol/1 and/or a previous clinical diagnosis of type 2 diabetes. RESULTS Prevalences of hyperglycemia among adults in nonexposed, fetal exposed, early-childhood, mid-childhood, and late-childhood exposed cohorts were 2.4%, 5.7%, 3.9%, 3.4%, and 5.9%, respectively. In severely affected famine areas, fetal-exposed subjects had an increased risk of hyperglycemia compared with nonexposed subjects (odds ratio = 3.92; 95% CI: 1.64-9.39; P = 0.002); this difference was not observed in less severely affected famine areas (odds ratio = 0.57; 95% CI: 0.25-1.31; P = 0.185). The odds ratios were significantly different between groups from the severe and less severe famine areas (P for interaction = 0.001). In severely affected famine areas, fetal-exposed subjects who followed an affluent/Western dietary pattern (odds ratios = 7.63; 95% CI: 2.41-24.1; P = 0.0005) or who had a higher economic status in later life experienced a substantially elevated risk of hyperglycemia (odds ratios = 6.20; 95% Cl: 2.08-18.5; P = 0.001). CONCLUSIONS Fetal exposure to the severe Chinese famine increases the risk of hyperglycemia in adulthood. This association appears to be exacerbated by a nutritionally rich environment in later life. Diabetes 59:2400-2406, 2010
Original languageEnglish
Pages (from-to)2400-2406
Number of pages6
JournalDiabetes
Volume59
Issue number10
DOIs
Publication statusPublished - 2010

Keywords

  • beta-cell mass
  • in-utero
  • disease
  • health
  • malnutrition
  • hypothesis
  • overweight
  • fetal

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