TY - JOUR
T1 - Early life famine exposure, ideal cardiovascular health metrics, and risk of incident diabetes
T2 - Findings from the 4C study
AU - Lu, Jieli
AU - Li, Mian
AU - Xu, Yu
AU - Bi, Yufang
AU - Qin, Yingfen
AU - Li, Qiang
AU - Wang, Tiange
AU - Hu, Ruying
AU - Shi, Lixin
AU - Su, Qing
AU - Xu, Min
AU - Zhao, Zhiyun
AU - Chen, Yuhong
AU - Yu, Xuefeng
AU - Yan, Li
AU - Du, Rui
AU - Hu, Chunyan
AU - Qin, Guijun
AU - Wan, Qin
AU - Chen, Gang
AU - Dai, Meng
AU - Zhang, Di
AU - Gao, Zhengnan
AU - Wang, Guixia
AU - Shen, Feixia
AU - Luo, Zuojie
AU - Chen, Li
AU - Huo, Yanan
AU - Ye, Zhen
AU - Tang, Xulei
AU - Zhang, Yinfei
AU - Liu, Chao
AU - Wang, Youmin
AU - Wu, Shengli
AU - Yang, Tao
AU - Deng, Huacong
AU - Li, Donghui
AU - Lai, Shenghan
AU - Bloomgarden, Zachary T.
AU - Chen, Lulu
AU - Zhao, Jiajun
AU - Mu, Yiming
AU - Ning, Guang
AU - Wang, Weiqing
N1 - Funding Information:
Acknowledgments.Theauthorsthankallofthe study participants. Funding. The research reported in this publication was supported by the National Basic Research Program of China (973 Program) (award 2015CB553601), the Ministry of Science and Technology of the People’s Republic of China (awards 2016YFC1305600, 2016YFC1305202, 2016YFC1304904, and 2017YFC1310700), the National Natural Science Foundation of China (awards 81700764, 81670795, 81621061, and 81561128019), National Major Scientific and Technological Special Project for “Significant New Drugs Development” (award 2017ZX09304007), and the Innovative Research Team of High-Level Local Universities in Shanghai. Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. J.L., Y.B., G.N., and W.W. conceived and designed the study. J.L., M.L., and R.D. analyzed data. Y.Q., Q.L., R.H., L.S., Q.S., Z.Z., X.Y.,L.Y.,G.Q.,Q.W.,G.C.,Z.G.,G.W.,F.S.,Z.L.,LiC., Y.H.,Z.Y.,X.T.,Y.Z.,C.L.,Y.W.,S.W.,T.Y.,H.D.,Lu.C., J.Z., and Y.M. collected data. All authors were involved in writing and revising the paper and had final approval of the submitted and published versions. Y.B., G.N., and W.W. are the guarantors ofthisworkand,assuch,hadfullaccesstoallofthe data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding Information:
The research reported in this publication was supported by the National Basic Research Program of China (973 Program) (award 2015CB553601), the Ministry of Science and Technology of the People?s Republic of China (awards 2016YFC1305600, 2016YFC1305202, 2016YFC1304904, and 2017YFC1310700), the National Natural Science Foundation of China (awards 81700764, 81670795, 81621061, and 81561128019), National Major Scientific and Technological Special Project for ?Significant New Drugs Development? (award 2017ZX09304007), and the Innovative Research Team of High-Level Local Universities in Shanghai.
Publisher Copyright:
© 2020 by the American Diabetes Association.
PY - 2020/8
Y1 - 2020/8
N2 - OBJECTIVE We aim to investigate the impact of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and adulthood diabetes risk. RESEARCH DESIGN AND METHODS This study included 77,925 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study who were born around the time of the Chinese Great Famine and free of diabetes at baseline. They were divided into three famine exposure groups according to the birth year, including nonexposed (1963–1974), fetal exposed (1959–1962), and childhood exposed (1949–1958). Relative risk regression was used to examine the associations between famine exposure and ICVHMs on diabetes. RESULTS During a mean follow-up of 3.6 years, the cumulative incidence of diabetes was 4.2%, 6.0%, and 7.5% in nonexposed, fetal-exposed, and childhood-exposed participants, respectively. Compared with nonexposed participants, fetal-exposed but not childhood-exposed participants had increased risks of diabetes, with multivariable-adjusted risk ratios (RRs) (95% CIs) of 1.17 (1.05–1.31) and 1.12 (0.96– 1.30), respectively. Increased diabetes riskswere observed in fetal-exposed individuals with nonideal dietary habits, nonideal physical activity, BMI ‡24.0 kg/m2, or blood pressure ‡120/80 mmHg, whereas significant interaction was detected only in BMI strata (P for interaction 5 0.0018). Significant interactions have been detected between number of ICVHMs and famine exposure on the risk of diabetes (P for interaction 5 0.0005). The increased risk was observed in fetal-exposed participants with one or fewer ICVHMs (RR 1.59 [95% CI 1.24–2.04]), but not in those with two or more ICVHMs. CONCLUSIONS The increased risk of diabetes associated with famine exposure appears to be modified by the presence of ICVHMs.
AB - OBJECTIVE We aim to investigate the impact of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and adulthood diabetes risk. RESEARCH DESIGN AND METHODS This study included 77,925 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study who were born around the time of the Chinese Great Famine and free of diabetes at baseline. They were divided into three famine exposure groups according to the birth year, including nonexposed (1963–1974), fetal exposed (1959–1962), and childhood exposed (1949–1958). Relative risk regression was used to examine the associations between famine exposure and ICVHMs on diabetes. RESULTS During a mean follow-up of 3.6 years, the cumulative incidence of diabetes was 4.2%, 6.0%, and 7.5% in nonexposed, fetal-exposed, and childhood-exposed participants, respectively. Compared with nonexposed participants, fetal-exposed but not childhood-exposed participants had increased risks of diabetes, with multivariable-adjusted risk ratios (RRs) (95% CIs) of 1.17 (1.05–1.31) and 1.12 (0.96– 1.30), respectively. Increased diabetes riskswere observed in fetal-exposed individuals with nonideal dietary habits, nonideal physical activity, BMI ‡24.0 kg/m2, or blood pressure ‡120/80 mmHg, whereas significant interaction was detected only in BMI strata (P for interaction 5 0.0018). Significant interactions have been detected between number of ICVHMs and famine exposure on the risk of diabetes (P for interaction 5 0.0005). The increased risk was observed in fetal-exposed participants with one or fewer ICVHMs (RR 1.59 [95% CI 1.24–2.04]), but not in those with two or more ICVHMs. CONCLUSIONS The increased risk of diabetes associated with famine exposure appears to be modified by the presence of ICVHMs.
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U2 - 10.2337/dc19-2325
DO - 10.2337/dc19-2325
M3 - Article
C2 - 32499384
AN - SCOPUS:85088008860
SN - 0149-5992
VL - 43
SP - 1902
EP - 1909
JO - Diabetes care
JF - Diabetes care
IS - 8
ER -