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Seasonality of birth in adult type 2 diabetic patients in three Ukrainian regions

2009; Springer Science+Business Media; Volume: 52; Issue: 12 Linguagem: Inglês

10.1007/s00125-009-1519-0

1432-0428

Alexander Vaiserman, Mykola Khalangot, Bendix Carstensen, М.D. Тronko, Víctor Kravchenko, V. P. Voitenko, L. V. Mechova, N. M. Koshel, P. E. Grigoriev,

Diet and metabolism studies

Keywords Birthcohorts.Early-lifeconditions.Month-of-birthpattern.Type2diabetesTo the Editor: Epidemiological studies have repeatedlyshown a link between poor fetal growth and increased riskof developing type 2 diabetes [1]. Month of birth is a goodinstrument for the assessment of effects of early growth onadult health independent of life-course factors. This is truebecause in decades past there were important seasonaldifferences in nutrition, especially in developing countriessuch as Ukraine. These differences in access to high-qualityfood supply can potentially influence intrauterine growth,depending on the month of gestation [2]. Other possibletriggering factors for developing type 2 diabetes, such asproduction of vitamin D [3] and outdoor temperature [4],also tend to change seasonally.Seasonal pattern of birth in type 1 diabetic children andadolescents was repeatedly described around the world,including our recent study in Ukraine [5]. In contrast, theseasonality of birth in type 2 diabetic patients waspreviously reported only in a few small-sample studies,e.g. in 155 African-American type 2 diabetic adolescent [6]and 282 adult patients in the Netherlands [7]. To studywhether abnormal seasonality of birth exists in middle- toold-aged type 2 diabetic patients in Ukraine, we comparedthe month-of-birth patterns in type 2 diabetic patients in threelarge Ukrainian regions with those in general populations.Information on date of birth, sex and year of diagnosiswas extracted from the nationwide primary-care-basedUkrainian diabetes mellitus register created in 2000 in theInstitute of Endocrinology, Kiev, Ukraine. The definition oftype 2 diabetes was based on onset after 39 years of age,irrespective of the type of treatment.Cases were identified from the three regional diabetesregisters with high completeness of ascertainment: Cherni-giv (100%), Kherson (99.7%) and Rivne (86.2%). Theseregisters cover 7.4% of the total Ukraine population. Afemale excess was evident in all three registers. Cases wereall people alive with diagnosis of type 2 diabetes as of1 January 2008, and who were diagnosed at age 40 or later.Only people born before 1 January 1960 were included;thus all cases included were at least 48. In total, 17,510male and 34,704 female type 2 diabetic patients werefinally included in the study. Reference populations werebased on the Ukraine census 2001 depersonalised data.These populations included people who had been bornduring the same period and were residents of the sameregions: Chernigiv, 247,253 men and 369,357 women;Kherson, 208,944 men and 291,802 women; Rivne,189,887 men and 260,674 women.