Diabetes incidence in Austria: The role of famines on diabetes and related NCDs

Kaleta, Michaela; Leutner, Michael; Thurner, Stefan; Kautzky, Alexander; Endel, Gottfried; Kiss, Noemi; Robausch, Martin; Kautzky‐Willer, Alexandra; Klimek, Peter

doi:10.1016/j.heliyon.2023.e17570

Cited by 3 publications

(2 citation statements)

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“…According to the Developmental Origins of Health and Disease (DOHaD) hypothesis, seeds of CHD, CVD, and NCDs are sown in early life, covering the intrauterine period as well as early childhood and adolescence ( 12–14 ). There are reports from Europe and China on early life undernutrition leading to dyslipidemia ( 15–17 ) as well as diabetes ( 18 , 19 ) in adult life. Though dyslipidemia has been interconnected to the pathophysiology of CVD, it is also a modifiable dominant risk factor if detected early in life ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Associations of micronutrients and lipids with prediabetes and glycemic parameters in adolescent girls of the rural DERVAN cohort (DERVAN-9)

Patil,

Dervankar,

Hardikar-Bhat

et al. 2024

Front. Nutr.

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BackgroundWe investigated the associations of micronutrients and lipids with prediabetes, glycemic parameters, and glycemic indices among the adolescent girls of the DERVAN (aDolescent and prEconception health peRspectiVe of Adult Non-communicable diseases) cohort study from rural India.MethodsWe recruited 1,520 adolescent girls aged 16–18 years. We measured glycemic parameters (glucose, insulin and HbA1C), lipids (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and triglycerides), and micronutrients (vitamin B12, folate, and vitamin D). Prediabetes was defined using American Diabetes Association criteria (fasting glucose ≥100 mg/dL or HbA1C ≥5.7%). Glycemic indices (insulin resistance, insulin sensitivity, and β cell function) were calculated using the homeostasis model. Associations of prediabetes, glycemic parameters and glycemic indices with micronutrients and lipids were analyzed by multiple logistic regressions.ResultsThe median age and Body Mass Index (BMI) were 16.6 years and 17.6 kg/m2, respectively. Overall, 58% of girls had a low BMI. Median vitamin B12, folate, and vitamin D concentrations were 249.0 pg/mL, 6.1 ng/mL, and 14.2 ng/mL, respectively. The deficiencies observed were 32.1% for vitamin B12, 11.8% for folate, and 33.0% for vitamin D. Median total cholesterol, LDL, HDL, and triglyceride concentrations were 148.0 mg/dL, 81.5 mg/dL, 50.8 mg/dL, and 61.5 mg/dL, respectively. Elevated total cholesterol, LDL, and triglycerides were observed in 4.8, 4.0, and 3.8%, respectively, while low HDL was observed in 12.8%. Prediabetes was observed in 39.7% of the girls. Among lipids, total cholesterol and LDL were higher in girls with prediabetes (p < 0.01 for both). In a multivariate model containing cholesterol and vitamin B12/folate/vitamin D, prediabetes was associated with high cholesterol. Prediabetes was also associated with high LDL, independent of folate and vitamin D. Poor insulin secretion was high in those with low vitamin B12. Elevated insulin resistance was associated with low HDL. The likelihood of high insulin sensitivity was reduced in those with high triglycerides. The likelihood of poor β cell function was high in those with high LDL. Statistical interactions between micronutrients and lipids for prediabetes and glycemic outcomes were not significant.ConclusionThere was a substantial deficiency of micronutrients and an absence of dyslipidemia. Our results indicate the need for lipid and micronutrient-based interventions in adolescence to improve glycemic outcomes. Maintaining adequate storage of not only micronutrients but also lipids in adolescent girls is likely to reduce diabetes risk in adulthood.

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Section: Introductionmentioning

confidence: 99%

Associations of micronutrients and lipids with prediabetes and glycemic parameters in adolescent girls of the rural DERVAN cohort (DERVAN-9)

Patil,

Dervankar,

Hardikar-Bhat

et al. 2024

Front. Nutr.

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“…For T2DM in later life, a regional study of the Ukraine famine together with local studies of the Dutch Famine of 1944-45, the Chinese Famine of 1959-61 and three famines in 20th century Austria all suggest a relation with prenatal nutrition. [6][7][8][9][10][11] We previously reported a 1.5-fold increase in T2DM in Ukraine among men and women born in four oblasts with extreme famine and a 1.3-fold increase in three oblasts with severe famine. 9 As potential limitations we noted that the population at risk for T2DM was defined by survivors included in the 2001 Ukraine census and that the study covered only nine out of 24 oblasts.…”

Section: Introductionmentioning

confidence: 99%

Long-term impact of pre-natal exposure to the Ukraine famine of 1932-1933 on adult type 2 diabetes mellitus

Lumey,

Li,

Khalangot

et al. 2023

Preprint

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ImportanceThe long-term impacts of early-life famine exposure on Type 2 Diabetes Mellitus (T2DM) have been widely documented across countries, but it remains less clear what is the critical time window and if there is a dose-response between famine intensity and risk of T2DM.ObjectiveTo establish the relation between prenatal famine exposure and adult Type 2 diabetes mellitus (T2DM).DesignA national cross-sectional study.SettingThe man-made Ukrainian Holodomor famine of 1932-1933.ParticipantsA total number of 128,225 T2DM cases diagnosed at age 40 or over from the national diabetes register 2000-2008 in Ukraine. The population at risk includes 10,186,016 Soviet Ukraine births (excepting one oblast/province) between 1930-1938 classified by month and year and oblast of birth.ExposureBirths born in January-June 1934 from oblasts that experienced extreme, severe, or significant famine in 1932-1933. Famine intensity was measured based on the excess mortality during the famine.Main Outcomes and MeasuresT2DM diagnosis was based on WHO (1999) criteria.ResultsWe observed in univariate analysis a 1.8-fold increase in T2DM (OR 1.80; 95% CI 1.74-1.85) among individuals born in the first half-year of 1934 in regions with extreme, severe, or significant famine. We observed no increase among individuals born in regions with no famine. In multivariate analysis across regions and adjusting for season of birth we observed a larger than 2-fold increase (OR 2.21; 95% CI 2.00-2.45). There was a dose-response by famine intensity, with ORs increasing from 1.94 to 2.39 across regions. The pattern was similar in men and women.Conclusions and RelevanceBirths in the first half-year of 1934 were conceived at the height of the Ukraine famine in 1933. This relation for T2DM outcomes points to early gestation as a critical time window relating maternal nutrition in pregnancy to offspring health in later life. Further studies of biological mechanisms should focus on this time window for which changes in DNA methylation and later body size have also been observed.Key PointsQuestionWhat is the critical time window for early-life famine exposure on Type 2 Diabetes Mellitus (T2DM)? Is there any dose-response relationship between early-life famine exposure and T2DM?FindingsWe found an increased risk of T2DM (Odds Ratio 2.21; 95% CI 2.00-2.45) among individuals born during the first half-year of 1934. A clear dose-response relationship was observed using excess mortality as a measure of famine intensity.MeaningEarly gestation is a critical time window relating maternal undernutrition in pregnancy to offspring health in later life.

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Fetal exposure to the Ukraine famine of 1932–1933 and adult type 2 diabetes mellitus

Lumey,

Li,

Khalangot

et al. 2024

Science

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The short-term impact of famines on death and disease is well documented, but estimating their potential long-term impact is difficult. We used the setting of the man-made Ukrainian Holodomor famine of 1932–1933 to examine the relation between prenatal famine and adult type 2 diabetes mellitus (T2DM). This ecological study included 128,225 T2DM cases diagnosed from 2000 to 2008 among 10,186,016 male and female Ukrainians born from 1930 to 1938. Individuals who were born in the first half-year of 1934, and hence exposed in early gestation to the mid-1933 peak famine period, had a greater than twofold likelihood of T2DM compared with that of unexposed controls. There was a dose-response relationship between severity of famine exposure and increase in adult T2DM risk.

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Diabetes incidence in Austria: The role of famines on diabetes and related NCDs

Cited by 3 publications

References 34 publications

Associations of micronutrients and lipids with prediabetes and glycemic parameters in adolescent girls of the rural DERVAN cohort (DERVAN-9)

Associations of micronutrients and lipids with prediabetes and glycemic parameters in adolescent girls of the rural DERVAN cohort (DERVAN-9)

Long-term impact of pre-natal exposure to the Ukraine famine of 1932-1933 on adult type 2 diabetes mellitus

Fetal exposure to the Ukraine famine of 1932–1933 and adult type 2 diabetes mellitus

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