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Cited by 384Birth, Development, and HealthGestational Diabetes Research and ManagementDietary Effects on Health

Exposure to the Chinese famine in early life and the risk of hyperglycemia and type 2 diabetes in adulthood

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Li, Yanping, He, Yuna, Qi, Lu, Jaddoe, Vincent W., Feskens, Edith J.M., Yang, Xiaoguang, Ma, Guansheng, Hu, Frank B.·2010·Diabetes
DOI 10.2337/db10-0385PMC PMC3279550
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Abstract

OBJECTIVE: Early developmental adaptations in response to undernutrition may play an essential role in susceptibility to type 2 diabetes, particularly for those experiencing a "mismatched rich nutritional environment" in later life. We examined the associations of exposure to the Chinese famine (1959-1961) during fetal life and childhood with the risk of hyperglycemia and type 2 diabetes in adulthood. RESEARCH DESIGN AND METHODS: We used the data for 7,874 rural adults born between 1954 and 1964 in selected communities from the cross-sectional 2002 China National Nutrition and Health Survey. Hyperglycemia was defined as fasting plasma glucose ≥6.1 mmol/l and/or 2-h plasma glucose ≥7.8 mmol/l and/or a previous clinical diagnosis of type 2 diabetes. RESULTS: Prevalences of hyperglycemia among adults in nonexposed, fetal exposed, early-childhood, mid-childhood, and late-childhood exposed cohorts were 2.4%, 5.7%, 3.9%, 3.4%, and 5.9%, respectively. In severely affected famine areas, fetal-exposed subjects had an increased risk of hyperglycemia compared with nonexposed subjects (odds ratio = 3.92; 95% CI: 1.64-9.39; P = 0.002); this difference was not observed in less severely affected famine areas (odds ratio = 0.57; 95% CI: 0.25-1.31; P = 0.185). The odds ratios were significantly different between groups from the severe and less severe famine areas (P for interaction = 0.001). In severely affected famine areas, fetal-exposed subjects who followed an affluent/Western dietary pattern (odds ratios = 7.63; 95% CI: 2.41-24.1; P = 0.0005) or who had a higher economic status in later life experienced a substantially elevated risk of hyperglycemia (odds ratios = 6.20; 95% CI: 2.08-18.5; P = 0.001). CONCLUSIONS: Fetal exposure to the severe Chinese famine increases the risk of hyperglycemia in adulthood. This association appears to be exacerbated by a nutritionally rich environment in later life.

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  • Compared with the relatively nonexposed cohort, the ORs of hyperglycemia in the fetal-exposed cohort were 7.63 (95% CI 2.41-24.1, P = 0.0005) for those who had an affluent/Western dietary pattern, and 2.34 (95% CI 0.82-6.70, P = 0.112) for those with a traditional dietary pattern.

    “Compared with the relatively nonexposed cohort, the ORs of hyperglycemia in the fetal-exposed cohort were 7.63 (95% CI 2.41–24.1, P = 0.0005) for those who had an affluent/Western dietary pattern, and 2.34 (95% CI 0.82–6.70, P = 0.112) for those with a traditional dietary pattern.”

    From Globalization of Diabetes (2011) · cites this paper as [57]

  • In the Chinese National Nutrition and Health Survey, the prevalence of hyperglycemia was highest (18.9%) in fetal-exposed subjects who consumed an affluent/Western diet during adulthood.

    “We found that the prevalence of hyperglycemia was highest (18.9%) in fetal-exposed subjects who consumed an affluent/Western diet during adulthood.”

    From Globalization of Diabetes (2011) · cites this paper as [57]

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  1. [27]State Statistical Bureau Quanguo Gesheng Zizhiqu Zhixiashi Lishi Tongji Ziliao Huibian, 1949–1989 (A Compilation of Historical Statistical Data of Provinces, Autonomous Regions, and Municipalities). Beijing China Statistical Press, 1990

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Authors
Li, Y., He, Y., Qi, L., Jaddoe, V. W., Feskens, E. J. M., Yang, X., Ma, G., & Hu, F. B.
Affiliations
  • Harvard University (US)
  • Chinese Center For Disease Control and Prevention (CN)
  • Brigham and Women's Hospital (US)
  • Wageningen University & Research (NL)
Corresponding author
  • Li, Yanping
  • Ma, Guansheng
  • Hu, Frank B.
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
2010-07-09
Volume
59
Issue
10
Pages
2400-2406
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
DOI
10.2337/db10-0385
PMC
PMC3279550
OpenAlex
W2144866168
Cited by
384
References
25
Citations by year
2026: 9 · 2025: 10 · 2024: 7 · 2023: 17 · 2022: 31 · 2021: 37 · 2020: 29 · 2019: 30 · 2018: 30 · 2017: 41 · 2016: 33 · 2015: 22 · 2014: 31 · 2013: 26 · 2012: 14
FWCI
16.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Socio-Environmental Systems Modeling (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • UNICEF
  • Danone
  • ZonMw (907.00303)
  • Department of Global Health and Population, Harvard T.H. Chan School of Public Health
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
Keywords
Chinese famine, fetal programming, developmental origins of health and disease, hyperglycemia, type 2 diabetes, malnutrition, child undernutrition, Western dietary pattern, economic status, fasting blood glucose, rural adults
MeSH terms
Adolescent, Adult, Blood Glucose, Child, Child, Preschool, China, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Family Characteristics, Female, Health Surveys, Humans, Hyperglycemia, Pregnancy, Prenatal Exposure Delayed Effects, Rural Population, Starvation, Urban Population, Cohort Studies, Prevalence

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