生命早期饥荒暴露对成年后患糖尿病及空腹血糖受损检出率的影响

Effects related to experiences of famine during early life on diabetes mellitus and impaired fasting glucose during adulthood

目的 探讨生命早期经历饥荒对成年后患糖尿病（DM）及IFG检出率的影响.方法 在参加2006-2007年度开滦集团健康体检的101 510名职工中,选取1956-10-01至1964-09-30期间在河北省出生并排除研究资料缺失者,最终纳入统计分析为19 347人.依据出生日期将1959-10-01至1961-09-30出生的研究对象作为饥荒暴露组,1958-10-01至1959-09-30和1961-10-01至1962-09-30的研究对象作为饥荒半暴露组,1956-10-01至1958-09-30和1962-10-01至1964-09-30的研究对象作为对照组,比较三组DM患病率、IFG检出率,并采用logistic回归模型分析生命早期经历饥荒对两者的影响.结果 饥荒暴露组DM患病率、IFG检出率分别为8.99％、8.96％,饥荒半暴露组分别为8.05％、9.35％,对照组分别为7.71％、8.20％.多因素logistic回归分析显示生命早期经历饥荒增加了成年后DM患病风险和IFG检出风险,OR值分别为1.218（95％CI：1.056 ～ 1.404,P=0.007）、1.142（95％CI：0.994～1.312,P=0.061）.性别分层后,男性人群OR直分别为1.163（95％CI：1.001 ～ 1.350,P=0.048）、1.213（95％CI：1.039～1.417,P=0.015）;女性人群OR值分别为1.319（95％CI：0.920～1.891,P=0.132）、0.990 （95％CI：0.679～ 1.444,P=0.959）.结论 生命早期经历饥荒增加了成年后DM患病、IFG检出风险,并主要表现在男性人群中.

Objective To investigate the effects of famine-experience during early life on diabetes mellitus and impaired fasting glucose in the adulthood.Methods In a total of 101 510 employees who took part in the health examination at the Kailuan Group between 2006 to 2007 were recruited.All the study subjects were born in Hebei province between 1956-10-01 and 1964-09-30 but those who had incomplete data were excluded.19 347 subjects were finally included for analysis.Members from the famine-exposed group were born between Oct.1,1959 and Sep.30,1961.There was a semi-exposed group with members born between Oct.1,1958 and Sept.30,1959 and from Oct.1,1961 to Sept.30,1962 but members from the control group were born from Oct.1,1956 to Sept.30,1958 and from Oct.1,1962 to Sept.30,1964.Prevalence rates on diabetes mellitus and the detection rate of impaired fasting glucose among the three groups were compared.Logistic regression model was used to analyze the effects of famine-experience during early life with the prevalence of diabetes mellitus and the detection rate of impaired fasting glucose during adulthood.Results Prevalence of diabetes mellitus and the detection rate of impaired fasting glucose in the famine-exposed adult-cohort groups were 8.99％,8.96％ while 8.05％ and 9.35％ in the semi-exposure groups,7.71％ and 8.20％ in the control group.Results from the multivariate logistic regression analysis showed that experiences of famine during early life increased the risk of diabetes mellitus and impaired fasting glucose in adulthood with the odds ratios as 1.218 （95％ CI：1.056-1.404,P=0.007） and 1.142 （95％ CI：0.994-1.312,P=0.061）.After stratification by sex,odds ratios in males were 1.163 （95％ C I：1.001-1.350,P=0.048） and 1.213 （95％ CI：1.039-1.417,P=0.015）.The odds ratios in females were 1.319 （95％ CI：0.920-1.891,P=0.132） and 0.990 （95％ CI：0.679-1.444,P=0.959）.Conclusion Experiences of famine during early life increased the risk of diabetes mellitus and impaired fasting glucose in the adulthood.However,this negative effect existed mainly in the males,according to the results from our study.