Abstract
Background: The historical origin for the T2D pandemic in China may lie in the 1959-1961 Chinese famine. This study is aimed to exam the associations between exposure to famine in early life and risks of diabetic complications in adult patients with T2D in China. Method: The participants in this study were selected from China National HbA1c Surveillance System (2009-2013), and further stratified according to the birth year. The participants born in 1959-1961 were classified as fetal exposed group (70852 participants). The participants born in 1956-1959 were classified as infant/toddler exposed group (93616 participants). The participants born in 1962-1964 were classified as unexposed group (72723 participants). By using the logistic regression approach, we analyzed the association between exposure to famine in early life and risks of diabetic complications. Results: As for diabetic complications, the adjusted model indicated that, compared with T2D without exposure to famine, the risks of coronary heart disease (fetal exposed: OR=1.254, 95%CI: 1.196-1.315; infant/toddler exposed: OR=1.343, 95%CI: 1.286-1.403), cerebrovascular disease (fetal exposed: OR=1.290, 95%CI: 1.200-1.388; infant/toddler: OR=1.342, 95%CI: 1.254-1.436) and diabetic retinopathy (fetal exposed: OR=1.083, 95%CI: 1.036-1.132) were significantly increased while the reduced risk of diabetic kidney disease (infant/toddler exposed:OR=0.885, 95%CI: 0.841-0.932) was observed in adult T2D patients with early-life exposure to famine. Conclusions: Early-life exposure to famine in patients with T2D was associated with increased risks of coronary heart disease, cerebrovascular disease, diabetic retinopathy but reduced risks of diabetic kidney disease in adulthood. Improving early-life nutritional status may promote better risk prevention and management of diabetic complications and comorbidities in patients with T2D. Disclosure C.Lin: None. X.Cai: None. L.Ji: Other Relationship; Eli Lilly and Company, Novo Nordisk, Merck & Co., Inc., Bayer Inc., Sanofi-Aventis U.S., Roche Pharmaceuticals, MSD Life Science Foundation, AstraZeneca, Boehringer Ingelheim Inc., Abbott, Metronics. Funding National Natural Science Foundation of China (81970698, 81970708); Beijing Natural Science Foundation (7202216)
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