Ning Feng, Zhao Jing, Zhang Lei, Wang Weijing, Sun Xiaohui, Song Xin, Zhang Yanlei, Xin Hualei, Gao Weiguo, Gao Ruqin, Zhang Dongfeng, Pang Zengchang
Qingdao Centers for Disease Control and Prevention, Qingdao 266033, China.
Qingdao Institute of Preventive Medicine, Qingdao 266033, China.
Nutr Res Pract. 2023 Aug;17(4):780-788. doi: 10.4162/nrp.2023.17.4.780. Epub 2023 Mar 13.
BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine.
SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates.
During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively ( < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively.
These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.
ClinicalTrials.gov Identifier: NCT01053195.
背景/目的：本研究探讨了1959 - 1961年中国饥荒期间早年饥荒暴露与成年后患2型糖尿病风险之间的关系。
受试者/方法：分别于2009年和2012年对2006年和2009年两项研究中3418名年龄在35 - 74岁且无糖尿病的个体进行前瞻性随访。饥荒暴露分为未暴露（出生于1962 - 1978年的个体）、胎儿期暴露（出生于1959 - 1961年的个体）、儿童期暴露（出生于1949 - 1958年的个体）以及青少年/成年期暴露（出生于1931 - 1948年的个体）。采用逻辑回归模型在对潜在协变量进行调整后评估饥荒暴露与糖尿病之间的关系。
在三年随访期间，未暴露组、胎儿期暴露组、儿童期暴露组和青少年/成年期暴露组的年龄调整后2型糖尿病发病率分别为5.7%、14.5%、12.7%和17.8%（<0.01）。在控制潜在协变量后，与未暴露组相比，胎儿期暴露组、儿童期暴露组和青少年/成年期暴露组患糖尿病的相对风险（95%置信区间）分别为2.15（1.29 - 3.60）、1.53（0.93 - 2.51）和1.65（0.75 - 3.63）。除城市化类型外，未观察到饥荒暴露与肥胖、教育水平以及糖尿病家族史之间的相互作用。胎儿期和儿童期经历饥荒暴露且生活在农村地区的个体患2型糖尿病的风险更高 , 相对风险分别为8.79（1.82 - 42.54）和2.33（1.17 - 4.65）。
这些发现表明早年饥荒暴露是2型糖尿病的独立预测因素，尤其是在女性中。早期识别和干预可能有助于预防晚年糖尿病。
ClinicalTrials.gov标识符：NCT01053195 。
