Si Jiahui, Yu Canqing, Guo Yu, Bian Zheng, Li Xia, Yang Ling, Chen Yiping, Sun Huarong, Yu Bo, Chen Junshi, Chen Zhengming, Lv Jun, Li Liming
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, People's Republic of China.
Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Diabetologia. 2017 May;60(5):836-842. doi: 10.1007/s00125-016-4200-4. Epub 2017 Jan 7.
AIMS/HYPOTHESIS: Season of birth as a surrogate for potential environmental exposure during fetal development and early postnatal life has shown an inconsistent association with adult type 2 diabetes in white populations living in high-latitude regions. The present study aimed to examine the association between birth seasonality and risk of adult type 2 diabetes in Chinese individuals living across wide regions of low latitude and lower to middle latitude.
Participants from the China Kadoorie Biobank were enrolled during 2004-2008 and followed up until 31 December 2013. After excluding participants with cancer, heart disease, stroke and diabetes at baseline, the present study included 189,153 men and 272,058 women aged 30-79 years. We used multivariable Cox proportional hazards model to estimate the HR and 95% CI.
During a median follow-up of 7.2 years (3.3 million person-years), we documented 8784 incident cases of type 2 diabetes. In the whole cohort, compared with summer-born participants, the adjusted HRs (95% CIs) were 1.09 (1.02, 1.16), 1.08 (1.02, 1.15) and 1.09 (1.02, 1.15) for those who were born in Spring, Autumn and Winter, respectively. The association was consistent in both men and women and across subgroups defined by residence and lifestyle factors later in life.
CONCLUSIONS/INTERPRETATION: In this large prospective study, participants born in summer had a lower risk of adult type 2 diabetes compared with other seasons of birth, suggesting exposures in early life with some degree of seasonal variation might influence the risk of adult diabetes.
目的/假设：出生季节作为胎儿发育和出生后早期潜在环境暴露的替代指标，在生活于高纬度地区的白人群体中，与成人2型糖尿病的关联并不一致。本研究旨在探讨出生季节与生活在低纬度和中低纬度广大地区的中国成年人2型糖尿病风险之间的关联。
来自中国嘉道理生物银行的参与者于2004年至2008年入组，并随访至2013年12月31日。在排除基线时患有癌症、心脏病、中风和糖尿病的参与者后，本研究纳入了189153名年龄在30 - 79岁的男性和272058名女性。我们使用多变量Cox比例风险模型来估计风险比（HR）和95%置信区间（CI）。
在中位随访7.2年（330万人年）期间，我们记录了8784例2型糖尿病发病病例。在整个队列中，与夏季出生的参与者相比，春季、秋季和冬季出生的参与者的校正HR（95%CI）分别为1.09（1.02，1.16）、1.08（1.02，1.15）和1.09（1.02，1.15）。这种关联在男性和女性中以及在根据居住和生活方式因素定义的亚组中都是一致的。
结论/解读：在这项大型前瞻性研究中，与其他出生季节相比，夏季出生的参与者患成人2型糖尿病的风险较低，这表明生命早期具有一定程度季节变化的暴露可能会影响成人糖尿病的风险。
