| Objective: It is a crucial time-window for individual's development and health during fetal and infant period.There are numerous studies have shown that early life exposure to major stress is associated with an increased risk of cardiovascular and metabolic disorders such as hypertension and diabetes in later life.When the exposure was happened in the significant period,especially the time period of susceptible during the pregnancy,it might change the matters,and possibly cause the pathological changes later in life.Diabetes mellitus(DM)is one of the most prevalent diseases in the modern world,and its endocrine and metabolic syndromes may be caused by genetic and environmental factors.The prevalence of DM is increased year by year.The most well-known factors that influence DM are obesity and physical inactivity,other factor as the social-psychological stress exposure still remains vague.There is of significant role in development of DM that the stress exposure has played.Quite a few studies have demonstrated that traumatic life event,job strain,general mood stress,anxiety or depression may be associated with increased risks to type 2 diabetes.As one of the most catastrophic disasters in history of China,Tangshan earthquake has caused the major impact on economy,society and other sides.Previous literature showed that individuals who exposed to the earthquake have the issues with increased prevalence of hypertension and DM during a short time,lost control of dysglycemia and dysarteriotony.Current research are more likely to focus on the short influences on physical and mental disorders of stress in adulthood,there are few studies have put emphasis on the long-term effects of exposure to prenatal and infancy stress.As a cross-sectional study,our research aims to investigate the individuals who were born during the Tangshan earthquake,through the blood glucose and the prevalence of DM among the subjects,we manage to find an association between the long-term effects and early life exposure,and investigate what or how the influence factors related to DM work after the early life exposure to earthquake.Hopefully can we not only propose new ideas about the pathogenesis of diabetes,but also provide scientific basis for the early prevention of diabetes mellitus.Methods: The subjects of this cross-sectional study were recruited from workers of Kailuan Mining Group.9 mining areas and 5 other institutes were investigated for total 1448 people.According to whether experienced the 1976 Tangshan earthquake is divided into two group,896 cases as exposed group and 552 cases as unexposed group.Comparison two groups of the general baseline data,experiences in childhood,life events in adult and social support status,analysis fasting glucose values and the incidence of diabetes mellitus and hypertension,while diabetes mellitus as the dependent variable,gender,age,education,alcohol consumption,smoking history,blood pressure,body mass index(BMI),family history of diabetes,triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL),bereavement and earthquake stress history as independent variables were analyzed with single-factor logistic regression analysis,then put the significant results into multivariate logistic regression analysis.All data were entered into the computer while dual check and entry in form epidata3.0 database,saved as REC format file,and a standard cross check of the data was carried out to ensure the accuracy and reliability of the data.All normal measurement data as mean ± standard deviation(x?s)said;between the two groups were compared using student t test;the descriptive statistics of count data were used as ratio,comparisons using chi-square test or Fisher's exact test;non-normality data using non-parametric tests.The related factors were analyzed by logistic regression analysis.Generally ? =0.05,enter? =0.05,out? =0.10 in the logistic regression,The p-value which was less than 0.05(two-tailed)was considered to indicate a significant difference.All statistical analyses were performed using the SPSS software package version 19.0(SPSS Inc.,Chicago,IL,USA).Results:The total number of all subjects is 1542,1448 meets the final criteria,include 1259 males(86.9%)and 189 females(13.1%),Han Nationality is the majority(97.9%),and most of subjects were coal miners(78.1%),the date of birth is between July 29 th 1975 and April 28 th 1978.85 subjects were found with the issues of diabetes mellitus,66 subjects(7.4%)suffered from the Tangshan earthquake and 19 subjects(3.4%)did not during pregnancy and infancy period.1 No significant differences were found in gender,nationality,marital status,occupation,birth weight,smoking history,alcohol consumption,bereavement and scores of CTQ,LES and SSRS between earthquake exposed group and unexposed group(P>0.05),Significant differences of two groups were found in age(Z=26.572,P =0.000),education(2? =7.299,P=0.026).2 No significant differences were found in BMI,TC,TC,LDL,HDL between the two groups(P>0.05).There are significant differences in the rate of DM(2? =9.518,P=0.002)and blood glucose(t =-1.965,P =0.050),but not in the rate of hypertension(P>0.05).3 Results of single factor logistic regression analysisThe factors influence on diabetes mellitus included gender,age,LDL,TG,TC,BMI,hypertension,family history,bereavement and earthquake stress were significant(P<0.05).4 Results of multivariate logistic regression analysisThe factors influence on diabetes mellitus included gender,LDL,TG,BMI,family history,bereavement and earthquake stress.The protective factor is female gender OR=0.221,95%CI(0.053,0.923),and the risk factors included LDL OR=1.597,95%CI(1.205,2.118),TG OR=1.179,95%CI(1.088,1.277),BMI OR=1.12,95%CI(1.037,1.21),family history OR=2.728,95%CI(1.421,5.24),bereavement OR=3.211,95%CI(1.841,5.600)and earthquake stress OR=2.405,95%CI(1.392,4.156).Conclusion:1 Early life exposure to earthquake increased the risks of diabetes mellitus,and early life exposure to bereavement is related to the long-term risks of diabetes mellitus.2 Higher level of TG and LDL,BMI,positive family history on DM are risk factors of diabetes mellitus. |
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