The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study

Zhenghe Wang,Jieyun Song,Yanhui Dong,Jun Ma,Zhiyong Zou,Luke Arnold,Bin Dong,Zhongping Yang

doi:10.1186/s12889-018-6134-x

Zhenghe Wang, Jieyun Song + Show 6 more

Open Access

https://doi.org/10.1186/s12889-018-6134-x

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Abstract

BackgroundThe associations of famine exposure with diabetes risk in adulthood are still unclear. This study aimed to explore the association between famine exposure in early life and risk of diabetes in adulthood.MethodsA total of 4138 subjects were selected from the data of the China Health and Retirement Longitudinal Study (CHARLS) 2011–2012. Diabetes was diagnosed as fasting plasma glucose (FPG) ≥7.0 mmol/L, glycated haemoglobin (HbA1C) > 6.5%, or self-reported diabetes. Birthdates of subjects were used to categorize famine exposure groups. The association of fetal-stage famine exposure with diabetes risk in adults was assessed using logistics regression model.ResultsThe prevalence of diabetes in the non-exposed, fetal-stage exposed, infant-stage exposed, and preschool-stage exposed groups were 9.0, 13.6, 12.7 and 10.8%, respectively. Compared with the age-balanced control group, the fetal-stage exposed group was associated with the elevated risk of diabetes in later life after adjusting for covariates (OR = 1.37; 95%CI: 1.09–1.72; P = 0.008). Stratified analysis showed that the association between prenatal famine exposure and diabetes risk in adulthood was comparable between severely affected areas and less severely affected areas (P for interaction =0.153).ConclusionsFamine exposure in fetal stages was associated with the elevated diabetes risk in adults, which could be the critical periods for relative intervention.

Highlights

The associations of famine exposure with diabetes risk in adulthood are still unclear
Using occupational or regional data, others researchers explored this association in the Chinese population, but the effect of age difference between exposed groups and non-exposed group was not controlled in those studies [16,17,18]
While Model 1 did not adjust for any covariate, Model 2 adjusted for sex and body mass index (BMI), and Model 3 further adjusted for smoking status, drinking status, physical activity level, the highest educational attainments of participants and their parents

Summary

Introduction

The associations of famine exposure with diabetes risk in adulthood are still unclear. This study aimed to explore the association between famine exposure in early life and risk of diabetes in adulthood. Several studies have found that famine exposure in early-life significantly increased the risk of non-communicable diseases in adulthood, including. Several studies assessed the relation between exposure to famine in early life and the risk of developing hyperglycemia or diabetes in the Chinese population [16,17,18,19]. Using occupational or regional data, others researchers explored this association in the Chinese population, but the effect of age difference between exposed groups and non-exposed group was not controlled in those studies [16,17,18]. Further research is needed to clarify that association with a comparable age between exposed and non-exposed groups [20, 21]

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