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Famine exposure increases cardiovascular risk due to hyperglycemia
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Individuals with fetal or childhood exposure to the Chinese famine of 1959 to 1961 who experienced hyperglycemia in adulthood appeared more likely to develop cardiovascular disease compared with those with lower fasting plasma glucose levels, according to findings published Nutrition, Metabolism & Cardiovascular Disease.
“A better identification of high-risk populations for CVD can lead to appropriate measures for intervention and prevention,” Chaofu Ke, PhD, of the department of epidemiology and biostatistics at the school of public health of the Medical College of Soochow University in Suzhou, Jiangsu, China, and colleagues wrote. “As hyperglycemia is an important risk factor for CVD and possesses high prevalence in China, it is of great significance to see whether the Great Chinese Famine modified the effect of hyperglycemia on CVD.”
Ke and colleagues identified 4,337 adults potentially affected by the famine during childhood who participated in the China Health and Retirement Longitudinal Study between 2011 and 2012. The researchers collected participant information — including the presence of CVD — from a study questionnaire and used blood samples to measure cholesterol, triglyceride and fasting blood glucose levels. According to the researchers, participants who said they had diabetes or high blood sugar were considered to have hyperglycemia, as were those who had a fasting plasma glucose level of at least 6.1 mmol/L or at least 7.8 mmol/L of 2-h plasma glucose.
The study included 952 participants born between October 1952 and September 1954 and exposed to famine in late childhood (mean age, 57.48 years; 52.42% women), 939 born between October 1954 and September 1956 and exposed in mid-childhood (mean age, 55.51 years; 53.25% women), 864 born between October 1956 and September 1958 and exposed in early childhood (mean age, 53.51 years; 52.55% women), 568 born between October 1959 and September 1961 who had fetal exposure to the famine (mean age, 50.57; 57.39% women), and 1,014 born between October 1962 and September 1964 who did not experience the famine (mean age, 47.53 years; 57.5% women).
Participants who experienced the famine in late childhood had a higher rate of CVD (15.24%) than those who experienced the famine in early childhood (13.55%) or in mid childhood (12.53%) or who had fetal exposure (11.86%) or who did not experience the famine (10.18%) (P = .0156). Those with late-childhood exposure also had a higher rate of hyperglycemia (34.77%) than the rest of the cohort (P < .0001).
Participants who had hyperglycemia appeared more likely to develop CVD regardless of their experience with the famine (OR = 1.27; 95% CI, 1.12-1.44), but the odds were more than doubled for those had fetal exposure to famine (OR = 2.55; 95% CI, 1.3-5.02) and significantly elevated for those exposed to the famine in mid-childhood (OR = 1.76; 95% CI, 1.06-2.9).
According to the researchers, the odds of developing CVD among those with hyperglycemia were five times higher if a participant was from a “severe famine area” compared with a less severe area (OR = 5.01; 95% CI, 1.22-20.66), more than four times higher if a participant was from a rural vs. nonrural region (OR = 4.67; 95% CI, 1.7-12.84) and more than three times higher for men vs. women (OR = 3.66; 95% CI, 1.01-13.33).
“This study provides evidence that Chinese famine modified the effects of hyperglycemia on CVD, especially in subjects who experienced exposure to famine in the fetal stage of life,” the researchers wrote. “The findings indicate that screening hyperglycemia among Chinese famine survivors and implementing intensive interventions and monitoring measures may benefit the prevention and control of CVD.” – by Phil Neuffer
Disclosures: The researchers report no relevant financial disclosures.
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