title: Prenatal exposure to famine and the development of hyperglycemia and type 2 diabetes in adulthood across consecutive generations: a population-based cohort study of families in Suihua, China.
abstract: There has been increased recognition that prenatal or perinatal nutrition has an effect on the development of type 2 diabetes (T2D) in adulthood, although studies that have directly examined whether the effect could be transmitted to the next generation remain sparse.
  
  
  
  We investigated the role of prenatal exposure to the Chinese famine in affecting future T2D risk in adulthood in 2 consecutive generations.
  
  
  
  A total of 1034 families, including 2068 parents [parental generation (F1)] and 1183 offspring [offspring generation (F2)], were recruited from the Suihua rural area that was affected by the Chinese Famine of 1959-1961. Participants born between 1 October 1959 and 30 September 1961 were defined as famine exposed, and those born between 1 October 1962 and 30 September 1964 were defined as nonexposed. The F2 were classified as having 1) no parent exposed to famine, 2) only a mother exposed to famine, 3) only a father exposed to famine, or 4) both parents exposed to famine. Classical risk factors for T2D as well as fasting-glucose- and oral-glucose-tolerance tests were measured in both the F1 and F2.
  
  
  
  Prenatal exposure to famine was associated with elevated risks of hyperglycemia (multivariable-adjusted OR: 1.93; 95% CI: 1.51, 2.48) and T2D (OR: 1.75; 95% CI: 1.20, 2.54) in adulthood in F1. Furthermore, compared with the offspring of nonexposed parents, the F2 with exposed parents- especially both exposed parents-had increased hyperglycemia risk (OR: 2.02; 95% CI: 1.12, 3.66) in adulthood.
  
  
  
  Prenatal exposure to famine remarkably increases hyperglycemia risk in 2 consecutive generations of Chinese adults independent of known T2D risk factors, which supports the notion that prenatal nutrition plays an important role in the development of T2D across consecutive generations of Chinese adults. This trial was registered at www.chictr.org.cn as ChiCTR-ECH-13003644.
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.|Departments of Epidemiology and.|Medicine, Center for Global Cardiometabolic Health, Brown University, Providence, RI.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Departments of Epidemiology and.|Medicine, Center for Global Cardiometabolic Health, Brown University, Providence, RI.
authors.forename: Simin
authors.initials: S
authors.lastname: Liu
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Songtao
authors.initials: S
authors.lastname: Li
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Rennan
authors.initials: R
authors.lastname: Feng
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Lixin
authors.initials: L
authors.lastname: Na
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Xia
authors.initials: X
authors.lastname: Chu
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Wu
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Yucun
authors.initials: Y
authors.lastname: Niu
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Zongxiang
authors.initials: Z
authors.lastname: Sun
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Han
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Haoyuan
authors.initials: H
authors.lastname: Deng
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Xing
authors.initials: X
authors.lastname: Meng
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Huan
authors.initials: H
authors.lastname: Xu
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Qiannuo
authors.initials: Q
authors.lastname: Qu
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and liying_helen@163.com sun2002changhao@126.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China; and liying_helen@163.com sun2002changhao@126.com.
authors.forename: Changhao
authors.initials: C
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002681:China; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000266:history; D005951:Glucose Tolerance Test; D049673:History, 20th Century; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010290:Parents; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D039401:Prenatal Nutritional Physiological Phenomena; D012307:Risk Factors; D013217:Starvation; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Chinese famine; hyperglycemia; prenatal; transgenerational; type 2 diabetes; undernutrition