Exposure to Chinese famine in early life modifies the association between hyperglycaemia and cardiovascular disease

Abstract Background and Aims The Great Leap Forward Famine in 1959-1961 was the world’s largest famine, and its adverse long-term effects might be more obvious in the coming decade with the ageing of the exposed populations. The aim of this study was to examine whether the Chinese Famine modified the effect of hyperglycaemia on cardiovascular disease (CVD). Methods and Results We used data from 4337 adults born between 1952 and 1964 from the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression was used to estimate the odds ratios (ORs) and confidence intervals (CIs) between hyperglycaemia and CVD. The prevalence of CVD was significantly differed among different famine exposure cohorts ( P =0.0156). After multivariable adjustment, the ORs (95% CIs) were as follows: 1.46(0.94, 2.26) for late childhood, 1.76(1.06, 2.90) for mid childhood, 1.40(0.86, 2.27) for early childhood, 2.55(1.30, 5.02) for the fetal cohort and 1.10(0.63, 1.95) for the non-exposed cohort. There was a significant interaction between hyperglycaemia and famine exposure for CVD ( P  = 0.0374). In addition, the subgroup analyses also showed that the effect of hyperglycaemia on CVD in the fetal exposed cohort was significantly higher than those in any of the other famine-exposed cohorts, especially in those who lived in rural areas (OR: 4.67, 95% CI: 1.70-12.84), those who lived in severe famine areas (OR: 5.01, 95% CI: 1.22-20.66) and those who were men (OR: 3.66, 95% CI: 1.01-13.33). Conclusion Exposure to the Chinese Famine, especially during the fetal stage of life, aggravated the association between hyperglycaemia and CVD.