Association between famine exposure in early life and type 2 diabetes mellitus and hyperglycemia in adulthood: Results from the China Health And Retirement Longitudinal Study (CHARLS)

J Diabetes. 2018 Sep;10(9):724-733. doi: 10.1111/1753-0407.12653. Epub 2018 Mar 25.


Background: Studies have revealed the association between famine in early life and type 2 diabetes mellitus (T2DM) in adulthood. However, studies on the Great Chinese Famine were not conducted nationwide. Because of regional variations in the severity of this famine, the results of regional studies are limited. This study explored associations between famine and T2DM in adulthood in a nationwide study.

Methods: The present study was performed on 7262 participants who were born between 1 October 1949 and 1 July 1966 using baseline data collected for the China Health And Retirement Longitudinal Study (CHARLS) in 2011. Participants were divided according to birthdate into cohorts with fetal, late, middle, and early childhood exposure and no exposure to famine. Logistic regression models were used to analyze the association between famine exposure in early life and the risk of T2DM and hyperglycemia in adulthood.

Results: For females, the risk of hyperglycemia was higher for famine-exposed than not exposed cohort (odds ratios [OR] 1.34 and 95% confidence intervals [CIs]: 1.34 [1.04-1.74], 1.48 [1.15-1.90], 1.38 [1.06-1.79], and 1.57 [1.25-1.98] for fetal, early, middle, and late childhood exposure, respectively), and this association was even stronger in female participants who lived in rural areas before the age of 16 years. In males, the risk of T2DM was lower for the early and late childhood exposure than no exposure cohorts (OR [95% CIs]: 0.65 [0.49-0.86] and 0.74 [0.56-0.98], respectively). [Correction added on 23 July 2018, after first online publication: Parts of the above 'Results' section have been corrected to interchange the citation of the words 'late' and 'early'.] CONCLUSION: Exposure to famine during early life can increase the risk of hyperglycemia in female adults, but may decrease the risk of T2DM in males.

Keywords: 2型糖尿病; childhood; famine; fetus; hyperglycemia; type 2 diabetes; 童年期; 胎儿期; 饥荒; 高血糖症.

MeSH terms

  • Adolescent
  • Asian People
  • Child
  • Child, Preschool
  • China
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Health Status
  • Humans
  • Hyperglycemia / ethnology
  • Hyperglycemia / etiology*
  • Infant
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pregnancy
  • Prenatal Exposure Delayed Effects / ethnology
  • Prenatal Exposure Delayed Effects / etiology*
  • Retirement
  • Starvation / complications*