Study results suggest that fetal- and late-childhood exposure to the severe Chinese famine of 1959-1961 is associated with significantly increased risk for hyperglycemia or Type 2 diabetes in later life.

The researchers found that individuals with fetal exposure to the famine who later followed an affluent or western style dietary pattern or who gained higher economic status than their peers had the highest overall risk for hyperglycemia.

The findings are in agreement with the developmental origins hypothesis which suggests that “adaptations in response to fetal undernutrition lead to metabolic and structural changes, which are beneficial for early survival but may increase the risk of common diseases such as Type 2 diabetes in adulthood.”

Yanping Li (Chinese Center for Disease Control and Prevention, Beijing, China) and colleagues analyzed data on 7874 adults from rural areas of China who were born between 1952 and 1964.

The team categorized the participants into five different famine exposure cohorts, namely: non-exposed (born 1962-1964; n=1954), fetal-exposed (born 1959-1961; n=1005), early-exposed (born 1952-1954; n=1654), mid-childhood exposed (born 1954-1956; n=1588), and late-childhood exposed (born 1956-1958; n=1673).

Hyperglycemia was defined as a fasting plasma glucose of 6.1 mmol/l or more, a 2-hour plasma glucose level of 7.8 mol/l or more, a prior diagnosis of Type 2 diabetes, or a combination of at least two of these three factors.

Overall, 2.4%, 5.7%, 3.9%, 3.4%, and 5.9%, of the non-, fetal-, early-, mid-childhood, and late-childhood exposed groups, respectively, had hyperglycemia.

In severely, but not less severely, affected famine areas (above or below 50% excess death rate, respectively), fetal-exposure increased the risk for later hyperglycemia a significant 3.92 fold compared with non-exposure.

In severely and less severely affected areas, late-childhood exposure increased the risk for adult hyperglycemia a significant 2.38 and 2.27 fold, respectively, compared with non-exposure. There was no significant effect of early- or mid-childhood exposure on the risk for later hyperglycemia across all famine-affected areas.

Interestingly, fetal-exposed participants who followed an affluent or western style dietary pattern and had higher economic status in later adulthood had a significant 7.63- and 6.20-fold increased risk for hyperglycemia, respectively, compared with non-exposed participants.

“Together with previous studies, our study highlights that early life environment is critical for the risk of hyperglycemia in adult life,” conclude the authors in the journal Diabetes.

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