Abstract

Context Insulin resistance and beta cell dysfunction are pivotal to the progression of metabolic diseases. Previous studies suggested famine exposure in early life was associated with type 2 diabetes, non-alcoholic fatty liver disease and metabolic syndrome, etc. But evidence in early famine exposure and insulin resistance and β-cell dysfunction were limited. Objective We aimed to investigate whether the association existed between famine exposure in early life and β cell dysfunction and insulin resistance in adulthood. Design and setting 10772 non-diabetic participants were enrolled in China based on SPECT-China study (ChiCTR-ECS-14005052, www.chictr.org.cn). Main outcome measure Insulin resistance was estimated by the homeostasis model assessment index of insulin resistance (HOMA-IR). Beta cell function, represented by insulin secretion, was estimated by the disposition index. The associations of famine exposure with HOMA-IR and disposition index were assessed via linear regression. Results In both men and women, the disposition indices were lower in fetal- and childhood- exposed subjects than non-exposed subjects. In women, the HOMA-IR levels were higher in fetal- and childhood- exposed subjects than non-exposed subjects. In men, we did not observe a significant association between the fetal- and childhood- exposed subjects and ln(HOMA-IR). However, in women, fetal- and childhood- exposed subjects were found to have significant association between famine exposure and ln(HOMA-IR). In both genders, the ln(disposition index) was observed to be significantly associated with fetal exposure to famine. Conclusions Exposure to famine in fetal- and childhood life period may lead to beta cell dysfunction and insulin resistance in non-diabetic male or/and females, which indicates malnutrition in early life period may offer a modifiable factor for type 2 diabetes development.

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