Table 3.
The impact of maternal nutrition factors on type 2 diabetes mellitus (T2DM) prevalence in offspring
| Reference (year). country, study type | Subjects (n, age range) | Data collection method | maternal nutrition factor | Outcomes |
|---|---|---|---|---|
| Li, Y et al [23] (2010). China, Retrospective Cohort |
7874 (1005 exposed to famine), 45-69 y |
Adults born between 1954-1964 in rural communities exposed to the Chinese famine. Follow-up data available from China's 2002 National Nutrition and Health Survey |
Exposure to the Chinese famine during pregnancy |
T2DM prevalence in exposed vs non-exposed (2.01% vs 1.37%). Risk of T2DM not significantly higher in exposed cohort (aOR = 1.43, 95% CI = 0.53-3.87). |
| Stanner et al [24] (1997). Russia, Cross-Sectional Study |
549 (169 exposed to famine), 52 y |
Offspring identified through the register for the Society of Children of the Siege and invited to attend to attend endocrinology clinic for measurement |
Exposure to the Leningrad siege during pregnancy (<300 carbohydrate calories/d) |
No significant difference in the prevalence of known T2DM with intrauterine exposure (mean 2.3% vs 3.6%) newly diagnosed T2DM (1.8% vs 2.7%), impaired glucose tolerance (9.6% vs 8.6%) compared to unexposed. No significant differences between prevalence rates in those exposed during gestation or infancy. |
| Hult M, et al. [25] (2010). Nigeria, Retrospective Cohort |
1339, 39-41 y |
Cohort of Igbo adults exposed to Biafran famine in gestation and early infancy. Convenience sample of offspring taken from six major market places. |
Exposure to the Biafran famine during pregnancy and early infancy |
Fetal-infant exposure to famine was associated with a significant increase in diabetes (OR = 3.11, 95% CI = 1.14-8.51), though when adjusted for BMI this was no longer significant (OR = 2.56, 95% CI = 0.92-7.17). |
| Lumey, LH et al [26] (2015).
Ukraine, Retrospective Cohort |
1 464 174 (599 759 exposed), 63-71 y |
Individuals born between 1930 and 1938 from the 2001 Ukraine national census as the reference population. Ukraine national diabetes register 2000-08 for T2DM diagnosed at aged >40 y. |
Exposure to the Ukraine famine during pregnancy |
Higher risk of T2DM in subjects born in regions with severe famine (aOR = 1.23, 95% CI = 1.07-1.40), and extreme famine (aOR = 1.51, 95% CI = 1.35-1.69) (combined for all regions and birth years) compared to individuals not exposed to famine (OR = 1.00, 95% CI = 0.91-1.09). |
| Thurner S, et al [27] (2013).
Austria, Cross-Sectional Study |
325 000, 62-91 y |
Database of the Main Association of Austrian Social Security Institutions – linked birth year with health care outpatient as well as inpatient care in Austria years of famine 1918-1919, 1938, 1946-1947. |
Exposure to famine during pregnancy |
Risk of developing T2DM was ∼ 13% higher in males and 16% in females than the national average for those born in the 1919-1921 famine compared to those born outside of famine. Excess risk of diabetes was 9% males/ 8% females for offspring born in 1938 famine, and 5% males, 3% female for those of 1946–1947. |
| Ekamper P, et al [22] (2015).
Netherlands, Retrospective Cohort |
41 096 men (22 952 exposed), 63 y |
Male conscripts included in the DFBC. Linked to military records of health and mortality. |
Exposure to famine during pregnancy (<900 kcal/d) |
Of 5011 deaths T2DM accounted for 115 (2.3%) deaths. There was no increased risk of T2DM related mortality following maternal exposure to famine prior to or during pregnancy (HR = 1.61, 95% CI = 0.91-2.86, P > 0.05). |
| Fall CH, et al [28] (1998). India, Cross-Sectional Study |
506 (76 with T2DM), 45-63 y |
Detailed obstetric records from Mysore hospital for pregnancies between 1934-1953. Cohort traced and recruited for hospital check up. |
Mother's BMI during pregnancy |
76 offspring (15%) diagnosed with T2DM. |
| Offspring incidence of T2DM increased with increasing maternal weight (10% with mothers under 43kg, 24% T2DM prevalence with mothers with maternal weight >49kg) | ||||
| Significant trend for diagnosis with T2DMs in offspring whose mothers had a higher body weight during pregnancy (P = 0.004). T2DM was also related to ponderal index. | ||||
| Dabelea D, et al [29] (2008). USA |
158, 10-22 y |
Offspring with T2DM recruited from the Diabetes in Youth Study. Maternal obesity recorded by mothers self-reported recall. |
Maternal obesity during pregnancy (BMI ≥25 kg/m2) |
79 subjects diagnosed with T2DM. Subjects with T2DM were more likely to have been exposed to maternal obesity during pregnancy (57% vs 27.4%, P < 0.0001), exposure to maternal obesity was independently associated with T2DM (aOR = 2.8, 95% CI = 1.5-5.2, P < 0.0001). |
| Eriksson JG, et al [18] (2014). Finland, Retrospective Cohort | N = 13 345, 70-80 y | Offspring of the HBC – maternal BMI measured prior to delivery and linked to offspring’s national health records. | Maternal overweight in pregnancy | Offspring’s risk of T2DM was significantly associated with increasing maternal BMI above 24 kg/m2 (BMI ≤24kg/m2 HR = 1.0 vs BMI ≥28 kg/m2 HR = 1.20, P < 0.05) with a HRfor trend per kg/m2 = 1.040 (95% CI = 1.013-1.068, P for trend = 0.004). |
aOR – adjusted odds ratio, HR – hazard ratio, BMI – body mass index, Cal – calorie, CVD – cardiovascular disease, HBC – Hamamatsu Birth Cohort, HR – heart rate, y – year