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Background/Objectives:To determine whether exposure to the Chinese famine during fetal life and early childhood was associated with a greater risk of metabolic syndrome in later life.Subjects/Methods:We used data of adults from the 2008 annual physical examinations in Public Health Center of the First Affiliated Hospital of Chongqing Medical University in Chongqing. To minimize misclassification of the famine exposure periods, subjects born in 1959 and 1962 were excluded. Totally, 5040 participants were enrolled and categorized into control (1963-1964), fetally exposed (1960-1961) and postnatally exposed (1957-1958) group. We adopted the definition of metabolic syndrome recommended by the Chinese Diabetes Society in 2004.Results:Women in fetally and postnatally exposed groups had significantly higher prevalences of metabolic syndrome than in control group (7.3% and 8.6% vs 4.0%, P<0.05, respectively). Women in fetally and postnatally exposed groups had a significantly higher risk of metabolic syndrome, as compared with control women (odds ratio (OR) 1.87 (95% confidence interval (CI) 1.15-3.04, P=0.012), OR 1.50 (95% CI 1.20-1.87, P=0.0003), respectively). Similar association was not observed among men. The prevalences of metabolic syndrome among men in control, fetally and postnatally exposed groups were 20.1%, 22.5% and 18.8%, respectively, but there was no significant difference of prevalences among the three groups.Conclusions:We found that exposure to the Chinese famine in early life period was associated with higher risk of metabolic syndrome in adulthood of women, but not men. This gender difference might be due to the mortality selection and son preference hypothesis. [ABSTRACT FROM AUTHOR]