Ten SNPs May Affect Type 2 Diabetes Risk in Interaction with Prenatal Exposure to Chinese Famine

Song, Chao; Ding, Chengri; Yuan, Fan; Feng, Ganyu; Ma, Yanning; Liu, Ailing

doi:10.3390/nu12123880

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…Fetal and childhood exposure to the Chinese famine, followed by high socioeconomic status during adulthood, were associated with increased T2DM incidence in several studies 80,81 . The effect of famine and malnutrition might be mediated by epigenetic changes 82,83 , decreased pancreatic β-cell proliferation and increased insulin resistance compared with individuals not exposed to famine or malnutrition 84 . In India, the prospective Pune Maternal Nutrition Study demonstrated that maternal undernutrition and vitamin B 12 prevalence observed in India and China, the known pancreatic β-cell defects associated with IFG and IGT and evidence from single-ethnic and multi-ethnic studies.…”

Section: Pathophysiological Mechanismsmentioning

confidence: 99%

Pathophysiology, phenotypes and management of type 2 diabetes mellitus in Indian and Chinese populations

et al. 2022

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| Nearly half of all adults with type 2 diabetes mellitus (T2DM) live in India and China. These populations have an underlying predisposition to deficient insulin secretion, which has a key role in the pathogenesis of T2DM. Indian and Chinese people might be more susceptible to hepatic or skeletal muscle insulin resistance, respectively, than other populations, resulting in specific forms of insulin deficiency. Cluster-based phenotypic analyses demonstrate a higher frequency of severe insulin-deficient diabetes mellitus and younger ages at diagnosis, lower β-cell function, lower insulin resistance and lower BMI among Indian and Chinese people compared with European people. Individuals diagnosed earliest in life have the most aggressive course of disease and the highest risk of complications. These characteristics might contribute to distinctive responses to glucose-lowering medications. Incretin-based agents are particularly effective for lowering glucose levels in these populations; they enhance incretin-augmented insulin secretion and suppress glucagon secretion. Sodium-glucose cotransporter 2 inhibitors might also lower blood levels of glucose especially effectively among Asian people, while α-glucosidase inhibitors are better tolerated in east Asian populations versus other populations. Further research is needed to better characterize and address the pathophysiology and phenotypes of T2DM in Indian and Chinese populations, and to further develop individualized treatment strategies.

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Section: Pathophysiological Mechanismsmentioning

confidence: 99%

Pathophysiology, phenotypes and management of type 2 diabetes mellitus in Indian and Chinese populations

et al. 2022

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“…The full-text review identified 32 original studies relating the Chinese famine to T2D. Fourteen studies used identical or overlapping data sources from the Kailuan Group Health Examination [ 28 , 29 ], the China Kadoorie Biobank (CKB) [ 30 , 31 ], the China National Nutrition and Health Survey (CNNHS) 2010–2012 [ 32 , 33 ], the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors Cohort (SPECT) [ 34 , 35 , 36 ], or the China Health and Retirement Longitudinal Studies (CHARLS) [ 37 , 38 , 39 , 40 , 41 ]. From these 14 studies, five studies were selected as the representative studies [ 28 , 30 , 33 , 34 , 38 ], and the other nine were excluded.…”

Section: Resultsmentioning

confidence: 99%

Early-Life Exposure to the Chinese Famine of 1959–1961 and Type 2 Diabetes in Adulthood: A Systematic Review and Meta-Analysis

Lumey

2022

Nutrients

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Background: The fast-growing literature suggests that the Chinese famine of 1959–1961 drives current and future type 2 diabetes (T2D) epidemics in China. This conclusion may be premature, as many Chinese famine studies have major methodological problems. We examine these problems, demonstrate how they bias the study results, and formulate recommendations to improve the quality of future studies. Methods: We searched English and Chinese databases for studies that examined the relationship between prenatal exposure to the Chinese famine and adult T2D from inception to 8 February 2022. We extracted information on T2D cases and study populations of individuals born during the famine (famine births), before the famine (prefamine births), and after the famine (postfamine births). We used random-effects models to compare the odds of T2D in famine births to several control groups, including postfamine births, combined pre- and postfamine births, and prefamine births. We used meta-regressions to examine the impacts of age differences between comparison groups on famine effect estimates and the role of other characteristics, including participant sex, age, and T2D assessments; famine intensity; residence; and publication language. Potential sources of heterogeneity and study quality were also evaluated. Results: Twenty-three studies met our inclusion criteria. The sample sizes ranged from less than 300 to more than 360,000 participants. All studies defined the famine exposure based on the participants’ dates of birth, and 18 studies compared famine births and postfamine births to estimate famine effects on T2D. The famine and postfamine births had an age difference of three years or more in all studies. The estimates of the famine effect varied by the selection of controls. Using postfamine births as controls, the OR for T2D among famine births was 1.50 (95% CI 1.34–1.68); using combined pre- and postfamine births as controls, the OR was 1.12 (95% CI 1.02–1.24); using prefamine births as controls, the OR was 0.89 (95% CI 0.79–1.00). The meta-regressions further showed that the famine effect estimates increased by over 1.05 times with each one-year increase in ignored age differences between famine births and controls. Other newly identified methodological problems included the poorly assessed famine intensity, unsuitable study settings for famine research, and poor confounding adjustment. Interpretation: The current estimates of a positive relationship between prenatal exposure to the Chinese famine and adult T2D are mainly driven by uncontrolled age differences between famine births and postfamine births. Studies with more rigorous methods, including age-balanced controls and robust famine intensity measures, are needed to quantify to what extent the famine exposure is related to current T2D patterns in China.

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“…When several studies were available on the same or overlapping cohorts reporting results of T2D and glucose dysregulation, we selected results from studies that either provided the most comprehensive information or had the largest sample size as representatives. Our search identified 14 Chinese famine studies on T2D using the same or overlapping data sources, including the Kailuan Group Health Examination, 25,26 China Kadoorie Biobank (CKB), 27,28 China National Nutrition and Health Survey (CNNHS) in 2010-12, 29,30 Survey on Prevalence in East China for Metabolic Diseases and Risk Factors Cohort (SPECT) in Shanghai, Jiangxi and Zhejiang, [31][32][33] China Health and Retirement Longitudinal Studies (CHARLS). [34][35][36][37][38] From them, five studies were selected as representative studies in our systematic review and meta-analysis.…”

Section: Search Strategy and Study Selectionmentioning

confidence: 99%

Early-life exposure to the Chinese famine of 1959-61 and type 2 diabetes in adulthood: a systematic review and meta-analysis

Lumey

2022

Preprint

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Background The Chinese famine of 1959-61 has been widely interpreted as an important driver of current and future type 2 diabetes (T2D) epidemics. We conducted a systematic review and meta-analysis of prenatal famine exposure and type 2 diabetes (T2D) in China to summarize study characteristics, examine impacts of control selections and other selected characteristics on study results, identify other characteristics influencing results, and formulate recommendations for future studies. Methods We searched English and Chinese databases for studies that examined the relationship between T2D and prenatal exposure to the Chinese famine up to February 8th, 2022. From included studies, we extracted information on the number of T2D cases and populations at risk among individuals born during the famine (famine births), before the famine (pre-famine births), and after the famine (post-famine births). We compared the risk of T2D in famine births to different controls: post-famine births, pre- and post-famine births combined, and pre-famine births. Heterogeneity across studies was assessed, and random-effects models were used to calculate summary estimates. Meta-regressions were used to examine the relationship between effect estimates and age differences. Subgroup analyses were performed based on selected characteristics, including participants' sex, age, T2D measurement, famine intensity, residence, and publication language. Findings In total, 23 studies met our inclusion criteria. Sample sizes ranged from below 300 to over 350,000. All studies defined famine exposure based on participants' date of birth, and 18 studies compared famine births to controls of post-famine births to estimate famine effects on T2D. Famine and post-famine births had an age difference of three years and over in each study. Using post-famine births as controls, a random-effects model shows an increased risk of T2D (OR 1.50, 95% CI 1.34-1.68) among famine births. In contrast, a marginally increased risk of T2D (OR 1.12, 95% CI 1.02-1.24) can be observed using pre- and post-famine births combined as controls, and a decreased risk (OR 0.89, 95% CI 0.79-1.00) using pre-famine births as controls. Studies with larger age differences between comparison groups had larger famine effects. Effect estimates comparing famine births to pre- and post-famine births combined depend on none of above selected characteristics. Studies showed a large variation in sampling sources, famine intensity assessment, and confounding adjustment. Interpretation Current estimates of a positive relation between prenatal exposure to the Chinese famine and adult T2D are mainly driven by uncontrolled age differences between famine births and post-famine controls. Marginal or no effects remain after controlling for the differences in most Chinese famine studies. It remains an open question to what extent the famine is related to current T2D patterns in China. Studies with more rigorous methods including age-balanced controls and robust famine intensity measures will be needed to quantify this relationship. Funding None.

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Ten SNPs May Affect Type 2 Diabetes Risk in Interaction with Prenatal Exposure to Chinese Famine

Cited by 9 publications

References 34 publications

Pathophysiology, phenotypes and management of type 2 diabetes mellitus in Indian and Chinese populations

Pathophysiology, phenotypes and management of type 2 diabetes mellitus in Indian and Chinese populations

Early-Life Exposure to the Chinese Famine of 1959–1961 and Type 2 Diabetes in Adulthood: A Systematic Review and Meta-Analysis

Early-life exposure to the Chinese famine of 1959-61 and type 2 diabetes in adulthood: a systematic review and meta-analysis

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