Department of Public Health, Qingdao University Medical College, Qingdao, 266021, Shandong Province, China.
Qingdao Municipal Center for Disease Control and Prevention, Qingdao, 266033, Shandong Province, China.
Eur J Nutr. 2018 Mar;57(2):741-749. doi: 10.1007/s00394-016-1363-1. Epub 2016 Dec 20.
The association between famine exposure (defined as lengthy and continuous deprivation of food) during early life and type 2 diabetes (T2DM) in adulthood remains controversial. A meta-analysis was performed to better clarify the relation of famine exposure to later T2DM risk.
A systematic literature search was performed in PubMed, Web of Science, Embase and China National Knowledge Infrastructure for relevant available articles. The articles were limited to those in English or Chinese from January 1990 to June 2016. Observational studies evaluating the association between famine exposure and T2DM were included. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of famine exposure on T2DM. The I was used to assess heterogeneity, and the random effects model (REM) was adopted as the pooling method.
We included 11 published articles with 12391 T2DM cases for this meta-analysis. A significant association of early life famine exposure with increased risk of T2DM was observed (RR = 1.38, 95% CI 1.17-1.63; I = 63.4%; P = 0.002). Compared with the unexposed, the RRs of T2DM were 1.36 (95% CI 1.12-1.65) for fetal-infant exposed and 1.40 (95% CI 0.98-1.99) for childhood exposed. After excluding one article that had a strong effect on heterogeneity, the pooled RR was 1.46 (95% CI 1.27-1.69).
The meta-analysis indicates that famine exposure during early life especially fetal-infant exposure may increase the risk of T2DM in adulthood. Measures should be taken to prevent malnutrition during important stages of growth and development to reduce the prevalence of T2DM.
生命早期饥荒暴露（定义为长时间和持续的食物剥夺）与成年 2 型糖尿病（T2DM）之间的关系仍存在争议。进行了一项荟萃分析，以更好地阐明饥荒暴露与以后发生 T2DM 风险的关系。
在 PubMed、Web of Science、Embase 和中国国家知识基础设施中进行了系统的文献检索，以获取相关的可用文章。这些文章仅限于 1990 年 1 月至 2016 年 6 月以英文或中文发表的文章。纳入评估饥荒暴露与 T2DM 之间关系的观察性研究。使用合并相对风险（RR）及其 95%置信区间（CI）来估计饥荒暴露对 T2DM 的影响。采用 I ² 评估异质性，采用随机效应模型（REM）作为合并方法。
本荟萃分析纳入了 11 篇已发表的文章，共纳入 12391 例 T2DM 病例。观察到生命早期饥荒暴露与 T2DM 风险增加显著相关（RR=1.38，95%CI 1.17-1.63；I ² =63.4%；P=0.002）。与未暴露者相比，胎儿-婴儿期暴露者的 T2DM 相对风险为 1.36（95%CI 1.12-1.65），儿童期暴露者的 T2DM 相对风险为 1.40（95%CI 0.98-1.99）。排除一篇对异质性有显著影响的文章后，合并 RR 为 1.46（95%CI 1.27-1.69）。
荟萃分析表明，生命早期特别是胎儿-婴儿期的饥荒暴露可能会增加成年后患 T2DM 的风险。应采取措施防止生长发育重要阶段的营养不良，以降低 T2DM 的患病率。
