Exposure to severe famine in the prenatal or postnatal period and the development of diabetes in adulthood: an observational study
Aims/hypothesis Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the...
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| Vydané v: | Diabetologia Ročník 60; číslo 2; s. 262 - 269 |
|---|---|
| Hlavní autori: | , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.02.2017
Springer Nature B.V |
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| ISSN: | 0012-186X, 1432-0428, 1432-0428 |
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| Abstract | Aims/hypothesis
Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China’s Great Famine (1959–1962).
Methods
Data from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA
1c
and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages.
Results
Individuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA
1c
, respectively, (all
p
< 0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found (
p
< 0.05).
Conclusions/interpretation
Exposure to severe famine in the fetal or childhood period may predict a higher HbA
1c
and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes. |
|---|---|
| AbstractList | Aims/hypothesis Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China's Great Famine (1959-1962). Methods Data from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA1c and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages. Results Individuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA1c, respectively, (all p<0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found (p<0.05). Conclusions/interpretation Exposure to severe famine in the fetal or childhood period may predict a higher HbA1c and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes. Aims/hypothesis Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China’s Great Famine (1959–1962). Methods Data from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA 1c and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages. Results Individuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA 1c , respectively, (all p < 0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found ( p < 0.05). Conclusions/interpretation Exposure to severe famine in the fetal or childhood period may predict a higher HbA 1c and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes. Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China's Great Famine (1959-1962). Data from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA sub(1c) and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages. Individuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA sub(1c), respectively, (all p<0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found (p<0.05). Exposure to severe famine in the fetal or childhood period may predict a higher HbA sub(1c) and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes. Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China's Great Famine (1959-1962).AIMS/HYPOTHESISLimited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China's Great Famine (1959-1962).Data from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA1c and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages.METHODSData from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA1c and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages.Individuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA1c, respectively, (all p < 0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found (p < 0.05).RESULTSIndividuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA1c, respectively, (all p < 0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found (p < 0.05).Exposure to severe famine in the fetal or childhood period may predict a higher HbA1c and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes.CONCLUSIONS/INTERPRETATIONExposure to severe famine in the fetal or childhood period may predict a higher HbA1c and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes. Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to measure the association between diabetes in adulthood and the exposure to different degrees of famine early in life (during the prenatal or postnatal period) during China's Great Famine (1959-1962). Data from 3967 individuals were included (a total of 2115 individuals from areas severely affected by famine, 1858 from moderately affected areas, 6 excluded due to missing data). A total of 2335 famine-exposed individuals were further divided into those exposed during the fetal stage, childhood or adolescence/young adulthood. We constructed a difference-in-differences model to compare HbA and fasting plasma glucose among the participants exposed to different degrees of famine intensity at different life stages. Logistic analyses were used as measures of the association between diabetes and the different levels of famine severity at different life stages. Individuals who had been exposed to famine during the fetal period, childhood, and adolescence/adulthood and who had lived in a severely affected area had a 0.31%, 0.20% and 0.27% higher HbA , respectively, (all p < 0.01) compared with unexposed individuals. After adjusting for age, sex, smoking status, education level and waist circumference, participants exposed to severe famine during the fetal stage (OR 1.90, 95% CI 1.12, 3.21) and childhood (OR 1.44, 95% CI 1.06, 1.97) had significantly higher odds estimates. Unexposed participants living in severely and moderately affected areas had a comparable prevalence of diabetes (OR 1.22, 95% CI 0.80, 1.87). A significant interaction between famine exposure during the fetal and childhood periods and the level of severity in the area of exposure was found (p < 0.05). Exposure to severe famine in the fetal or childhood period may predict a higher HbA and an increased diabetes risk in adulthood. These results from China indicate that both the prenatal and postnatal period may offer critical time windows for the determination of the risk of diabetes. |
| Author | Wang, Ningjian Chen, Yi Jiang, Boren Jensen, Michael D. Li, Qin Cheng, Jing Lu, Yingli Xia, Fangzhen Han, Bing |
| Author_xml | – sequence: 1 givenname: Ningjian surname: Wang fullname: Wang, Ningjian organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 2 givenname: Jing surname: Cheng fullname: Cheng, Jing organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 3 givenname: Bing surname: Han fullname: Han, Bing organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 4 givenname: Qin surname: Li fullname: Li, Qin organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 5 givenname: Yi surname: Chen fullname: Chen, Yi organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 6 givenname: Fangzhen surname: Xia fullname: Xia, Fangzhen organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 7 givenname: Boren surname: Jiang fullname: Jiang, Boren organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine – sequence: 8 givenname: Michael D. surname: Jensen fullname: Jensen, Michael D. email: jensen@mayo.edu organization: Endocrine Research Unit – sequence: 9 givenname: Yingli surname: Lu fullname: Lu, Yingli email: luyingli2008@126.com organization: Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27807599$$D View this record in MEDLINE/PubMed |
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| Copyright | Springer-Verlag Berlin Heidelberg 2016 Diabetologia is a copyright of Springer, 2017. |
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| DOI | 10.1007/s00125-016-4148-4 |
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| PublicationSubtitle | Clinical and Experimental Diabetes and Metabolism |
| PublicationTitle | Diabetologia |
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Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing... Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing diabetes. We aimed to... Aims/hypothesis Limited studies have compared the effect of prenatal or postnatal exposure to different severities of famine on the risk of developing... |
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| SubjectTerms | Adult Adults Blood Glucose - metabolism Child development China - epidemiology Cross-Sectional Studies Diabetes Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology Famine Fasting Female Glucose Glycated Hemoglobin - metabolism Human Physiology Humans Internal Medicine Logistic Models Medicine Medicine & Public Health Metabolic Diseases Metabolic disorders Middle Aged Observational studies Pandemics Population Pregnancy Prenatal development Prenatal Exposure Delayed Effects Prevalence Risk factors Starvation - physiopathology |
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| Title | Exposure to severe famine in the prenatal or postnatal period and the development of diabetes in adulthood: an observational study |
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