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Reply to ‘Chinese famine and the diabetes mellitus epidemic’

Nature Reviews Endocrinology volume 16, pages 123–124 (2020)Cite this article

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We thank Zimmet et al. (Chinese famine and the diabetes mellitus epidemic. Nat. Rev. Endocrinol. https://doi.org/10.1038/s41574-019-0300-9 (2019))1 for their interest in our Comment (Li, C. et al. The effect of the Chinese Famine on type 2 diabetes mellitus epidemics. Nat. Rev. Endocrinol. 15, 313–314 (2019))2 and welcome the opportunity to address their main concerns.

Zimmet et al. are concerned that age-balanced controls could underestimate the risk of fetal famine exposure. This potential underestimation might be a problem and therefore needs further examination in famine settings. In studies of the Ukraine Holodomor famine of 1932–1933 and of the Dutch Hunger Winter famine of 1944–1945, we demonstrated that there was no difference in type 2 diabetes mellitus (T2DM) when we compared individuals born before the famine (and hence exposed during childhood) with individuals born after the famine3,4. We therefore combined these groups to form an age-balanced control group. We further addressed the age issue with difference in difference analytic methods, comparing the effect of famine in different severity areas. Findings in our Dutch famine study were also confirmed using same-sex siblings without famine exposure as controls1. These approaches protect from possible biases arising from the rapidly increasing prevalence of T2DM in these settings and in the Chinese population in the past few years.

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References

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Chihua Li & L. H. Lumey

  2. Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan, China

    Chihua Li

  3. Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands

    Elmar W. Tobi, Bastiaan T. Heijmans & L. H. Lumey

  4. Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands

    Elmar W. Tobi

Authors
  1. Chihua Li
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  2. Elmar W. Tobi
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  4. L. H. Lumey
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Correspondence to L. H. Lumey.

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Li, C., Tobi, E.W., Heijmans, B.T. et al. Reply to ‘Chinese famine and the diabetes mellitus epidemic’. Nat Rev Endocrinol 16, 123–124 (2020). https://doi.org/10.1038/s41574-019-0301-8

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