The effect of the Chinese Famine on type 2 diabetes mellitus epidemics

The Chinese Famine has been widely interpreted as an important contributor to subsequent epidemics of type 2 diabetes mellitus. Our re-examination of available studies challenges this apparent relationship. The definition of famine exposure and control selection needs more attention in future studies to better understand this potential association.

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  1. 1.

    Ravelli, A. C. et al. Glucose tolerance in adults after prenatal exposure to famine. Lancet 351, 173–177 (1998).

  2. 2.

    Lumey, L. H., Khalangot, M. D. & Vaiserman, A. M. Association between type 2 diabetes and prenatal exposure to the Ukraine famine of 1932–1933: a retrospective cohort study. Lancet Diabetes Endocrinol. 3, 787–794 (2015).

  3. 3.

    Zimmet, P. Z. et al. Epidemic T2DM, early development and epigenetics: implications of the Chinese Famine. Nat. Rev. Endocrinol. 14, 738–746 (2018).

  4. 4.

    Li, C. & Lumey, L. H. Exposure to the Chinese Famine of 1959–1961 in early life and long-term health conditions: a systematic review and meta-analysis. Int. J. Epidemiol. 46, 1157–1170 (2017).

  5. 5.

    Li, J. et al. 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. Am. J. Clin. Nutr. 105, 221–227 (2016).

  6. 6.

    Kazachenka, A. et al. Identification, characterization, and heritability of murine metastable epialleles: implications for non-genetic inheritance. Cell 175, 1259–1271 (2018).

  7. 7.

    Lumey, L. H. et al. Adult glucose dysregulation after severe prenatal food restriction in the Dutch Hunger Winter: only partial mediation by current body size. J. Dev. Orig. Health Dis. 8, S53 (2017).

  8. 8.

    Li, C. & Lumey, L. H. Interaction or mediation by adult obesity of the relation between fetal famine exposure and type 2 diabetes? Int. J. Epidemiol. (2019).

  9. 9.

    Hillier, T. A. et al. Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes Care 30, 2287–2292 (2007).

  10. 10.

    Allard, C. et al. Mendelian randomization supports causality between maternal hyperglycemia and epigenetic regulation of leptin gene in newborns. Epigenetics 10, 342–351 (2015).

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Correspondence to L. H. Lumey.

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