Abstract P178: Famine Exposure in the Young and the Risk of Type 2 Diabetes in Adulthood
Background The developmental origins hypothesis proposes that undernutrition during early development is associated with an increased risk of type 2 diabetes mellitus (T2DM) in adulthood. We investigated the association between moderate and severe undernutrition during childhood and young adulthood and the risk of T2DM in later life. Methods We studied 7,837 women from the Prospect-EPIC cohort who were exposed at various degrees to the short but severe 1944-1945 Dutch Famine when they were between 0 and 21 years. We used Cox proportional hazard regression models to explore the effect of famine exposure on the risk of subsequent T2DM in adult life. We adjusted for potential confounders, including age at famine exposure, smoking, and level of education as a proxy for socio-economic status. Findings Famine exposure during childhood and young adulthood was associated with an increased T2DM risk in a dose-dependent manner (p for trend <0·001). In those who were moderately famine exposed the T2DM hazard ratio (HR) was 1·36 (95% CI 1·09 to 1·69); in those severely famine exposed the HR was 1·64 (95% CI 1·26 to 2·13) relative to unexposed women. These effects did not materially change after adjustment for confounders (HR for moderate: 1·33, 95% CI 1·06 to 1·67; HR for severe: 1·51, 95% CI 1·16 to 1·98). Interpretation This study provides the first direct evidence, using individual famine exposure data, that a short period of moderate or severe undernutrition during postnatal development increases the risk of T2DM in adult life.
- © 2012 by American Heart Association, Inc.