%0 Journal Article
%T Early life exposure to 1959-1961 Chinese famine exacerbates association between diabetes and cardiovascular disease.
%A Shi Z
%A Ji L
%A Ma RCW
%A Zimmet P
%J J Diabetes
%V 12
%N 2
%D Feb 2020
%M 31390138
%F 4.53
%R 10.1111/1753-0407.12975
%X <B>BACKGROUND: </B>We aimed to assess whether early life exposure to the Chinese famine (1959-1961) modifies the association between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in adulthood.<BR><B>METHODS: </B>Data from 4247 adults born between 1954 and 1964 from the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS) were analyzed. CVD in 2011 and 2015 was based on self-reported doctor's diagnosis of cardiac events (heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems) and stroke. Diabetes in 2011 was defined by fasting blood glucose, HbA1C, or known diabetes.<BR><B>RESULTS: </B>Diabetes in 2011 was cross-sectionally associated with an increase of CVD risk in 2011 (OR 1.91, 95%CI 1.53-2.40, P < 0.001) after adjusting for age and gender. Famine exposure changed the association between diabetes and CVD in areas severely affected by famine. The odds ratios (OR) of diabetes in 2011 for CVD in 2015 were 1.24 (95%CI 0.73-2.10), 1.27 (95%CI 0.72-2.24), 2.25 (95%CI 1.29-3.91), 4.31 (95%CI 2.07-8.97) and 1.72 (95%CI 0.84-3.51) among adults in late childhood-, mid-childhood-, early childhood-, fetal-, and nonexposed cohorts in severe famine areas, respectively.<BR><B>CONCLUSIONS: </B>T2DM is associated with the risk of CVD among Chinese adults. Fetal and early childhood exposure to the Chinese famine exacerbated the associated risk.<BR>背景: 本研究旨在评估早年生活经历过中国饥荒(1959-1961年)是否会影响成年以后2型糖尿病(type 2 diabetes mellitus, T2DM)与心血管疾病(cardiovascular disease, CVD)之间的相关性。 方法: 分析了2011年至2015年中国健康与退休纵向研究(CHARLS)中4247名1954年至1964年间出生的成人的数据。根据自我报告医生诊断的心血管事件(心脏病发作、冠心病、心绞痛、充血性心力衰竭或其它心脏病)和卒中来确认2011年与2015年的CVD。2011年的糖尿病诊断是基于空腹血糖、HbA1C或已知糖尿病。 结果: 校正年龄与性别后, 发现2011年的糖尿病诊断与2011年CVD风险增加之间具有横向相关性(OR 1.91, 95% CI 1.53-2.40, P<0.001)。在遭受饥荒严重影响的地区, 经历过饥荒会改变糖尿病与CVD之间的相关性。在遭受过严重饥荒的地区, 儿童晚期、儿童中期、儿童早期、胎儿时期遭受过饥荒的队列和未遭受过饥荒的队列成年后在2011年的糖尿病诊断与2015年发生CVD的比值比(OR)分别为1.24(95% CI 0.73-2.10)、1.27(95% CI 0.72-2.24)、2.25(95% CI 1.29-3.91)、4.31(95% CI 2.07-8.97)和1.72(95% CI 0.84-3.51)。 结论: 中国成人中T2DM与CVD风险具有相关性。胎儿时期和儿童早期经历过中国饥荒可使相关风险加剧。.