Risk of Hyperglycemia and Diabetes after Early-Life Famine Exposure: A Cross-Sectional Survey in Northeastern China

Abstract

Previous studies suggested that malnutrition during early life may play an essential role in later outcomes and disease risk in adulthood. We aimed to investigate the risks of hyperglycemia and diabetes 50 years after early-life famine exposure in a Northeastern Chinese population. We used the data from 5690 adults born between 1956 and 1965 in selected communities from a 2012 cross-sectional study. The early-childhood exposure cohort showed an increased risk of hyperglycemia compared with the unexposed cohort in the female population (odds ratio (OR) 1.46; 95% confidence interval (CI) 1.04, 2.06). The increased risk of diabetes in the early-childhood and fetal exposure cohorts was 37.0% (95% CI 1.05–1.79) and 50% (95% CI 1.15–1.96), respectively. For women, the risk of diabetes was more pronounced in the fetal-exposed cohort (OR 1.82; 95% CI 1.26–2.63) than in the early-childhood cohort (OR 1.57; 95% CI 1.08–2.26). Early-life exposure to famine increased the risk of diabetes. Furthermore, early-childhood exposure to famine might increase the risk of hyperglycemia in women. A policy for preventing early life malnutrition should be drafted by the government to prevent hyperglycemia and diabetes in adulthood.

Foetal and childhood exposure to famine and the risks of cardiometabolic conditions in adulthood: A systematic review and meta‐analysis of observational studies

“…Of these 71 articles, 24 were further excluded for various reasons (Appendix S1). Finally, 47 articles were included in the present meta‐analysis. The articles were published between 2006 and 2019, mostly published from 2014 onwards.…”

“…Foetal exposure to famine was associated with higher risks of T2DM (RR 1.37, 95% CI, 1.23‐1.52; Figure ), metabolic syndrome (RR 1.26, 95% CI, 1.07‐1.50; Figure ), hypertension (RR 1.30, 95% CI, 1.07‐1.57; Figure ), hyperglycaemia (RR 1.27, 95% CI, 1.11‐1.45; Figure ), dyslipidaemia (RR 1.48, 95% CI, 1.33‐1.66; Figure 2), obesity (RR 1.19, 95% CI, 1.02‐1.39; Figure ), overweight (RR 1.17, 95% CI, 1.07‐1.29; Figure ), coronary heart disease (RR 1.22, 95% CI, 1.00‐1.51; Figure ), and moderate‐to‐severe NAFLD (RR 1.66, 95% CI, 1.07‐2.57; Figure 3) . No association was observed for the risks of stroke (RR 1.21, 95% CI, 0.96‐1.52; Figure ) or mild NAFLD (RR 1.04, 95% CI, 0.64‐1.70; Figure 3) .…”

Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review

“…31 45 46 48 49 Increased risk of hyperglycaemia in famine-exposed women was found in two Chinese studies. Both found similarly increased risk as a result of early childhood famine exposure (0-3 years; OR 1.48; 95% CI 1.15 to 1.9 48 ; OR 1.55; 95% CI 1.10 to 2.19 49 ), with one study finding further associations with exposure in mid-childhood (4-6 years; OR 1.38; 95% CI 1.06 to 1.79) and late childhood (7-10 years; OR 1.57; 95% CI 1.25 to 1.98). 48 49 By contrast, one of these studies found a decreased risk of diabetes in men exposed to famine in early (OR 0.65; 95% CI 0.49 to 0.86) and late childhood (OR 0.74; 95% CI 0.56 to 0.98) compared with controls.…”

Fetal Exposure to Chinese Famine Increases Obesity Risk in Adulthood

“…The Chinese famine from 1959 to 1961 is considered to be one of the largest and most severe famines, which provides an opportunity to explore the association between fetal famine exposure and health outcomes. Previous studies indicated that exposure to famine during early life may increase obesity, hypertension, diabetes and other diseases in adulthood [10][11][12][13]16,19,20,[22][23][24][25][26]28,30,32,33,[36][37][38][39][40][41][42]. Regarding obesity, some studies focused their attention on the fetal exposure to famine and BMI or WC in some regions of China or foreign countries [13,19,20,30,31,38,42].…”