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Liu X, Sun J, Ge B, Pan C, Yan H, Sun X, Peng J, Wang W, Lin Y, Zhang D, Ning F. Association between famine exposure during infancy and childhood and the risk of chronic kidney disease in adulthood. Intern Med J 2024; 54:1310-1319. [PMID: 38465389 DOI: 10.1111/imj.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/08/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Famine exposure in childhood is proven to be associated with multiple chornic disease in adult but has not been studied with chronic kidney disease (CKD). AIMS This study was conducted to identify the relationship between famine exposure during infancy and childhood - specifically, the Chinese famine of 1959-1961 - and the risk of adult-onset chronic kidney disease (CKD) among Chinese individuals. METHODS This study included 2937 individuals from the Qingdao Diabetes Prevention Program. They were stratified by birth year into infancy-exposed (1956-1958), childhood-exposed (1950-1955) and unexposed (1963-1971) groups. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined as an eGFR of <90 mL/min/1.73 m2. RESULTS The mean eGFR values for the infancy-exposed and childhood-exposed groups were 107.23 ± 12.53 and 103.23 ± 12.44 mL/min/1.73 m2, respectively, both of which were lower than that of the unexposed group (114.82 ± 13.39 mL/min/1.73 m2; P < 0.05). In the crude model, the odds ratio (OR) for CKD was 2.00 (95% confidence interval (CI): 1.39-2.88) in the infancy-exposed group and 2.92 (95% CI: 2.17-3.93) in the childhood-exposed group. Further adjustments for urban/rural residence, body mass index, age, current smoking, type 2 diabetes, systolic blood pressure, diastolic blood pressure and total cholesterol did not significantly alter the association between famine exposure and CKD. The corresponding ORs were 1.71 (95% CI: 1.17-2.50) and 2.48 (95% CI: 1.81-3.40) for the infancy-exposed and childhood-exposed groups respectively. CONCLUSIONS Famine exposure during infancy and childhood is associated with a long-term decline in eGFR and an increased adult-onset CKD risk. Early intervention for high-risk individuals may mitigate the risk of adult-onset CKD.
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Affiliation(s)
- Xiao Liu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Junhui Sun
- The Second People's Hospital of Jimo, Qingdao, Shandong, China
| | - Bing Ge
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Chi Pan
- Huangdao District Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Hongxuan Yan
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Xiaohui Sun
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Jiahui Peng
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Yongfeng Lin
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Feng Ning
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
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Meng R, Pei X, Yang D, Shang J, Cao Y, Wei S, Zhu Y. Consequences of Exposure to Famine Exposure on the Later Life eGFR Decline Among Survivors of the Great Chinese Famine: A Retrospective Study. J Ren Nutr 2024:S1051-2276(24)00091-8. [PMID: 38821451 DOI: 10.1053/j.jrn.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/25/2024] [Accepted: 05/13/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVES Chronic kidney disease (CKD) significantly contributes to the socio-economic burden both in China and worldwide. Previous research has shown that experiencing childhood famine is linked to various chronic conditions like diabetes, hypertension, and proteinuria. However, the long-term effects of early-life famine exposure on adult kidney function remain unclear. This study investigates whether exposure to the Chinese Great Famine (1959-1962) is associated with a decline in glomerular filtration rate (GFR) later in life. DESIGN AND METHODS China Health and Retirement Longitudinal Study is a population-based observational study. We analyzed data from 8,828 participants in the 2011-2012 baseline survey, updated in 2014. Participants were categorized based on their birth year into fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/adult-exposed (1912-1948), and nonexposed (1963-1989) groups. The estimated GFR (eGFR) was calculated using the CKD-EPI-Cr-Cys equation (2021), with CKD defined as an eGFR below 60 mL/min/1.73 m2. RESULTS Average eGFR values were 103.0, 96.8, 91.2, and 76.3 mL/min/1.73 m2 for the fetal-exposed, childhood-exposed, adolescence/adult-exposed, and nonexposed groups, respectively. The eGFR in the exposed groups was significantly lower compared to the nonexposed group. Specifically, famine exposure correlated with a lower eGFR (coefficient estimates [CE] -9.14, 95% confidence interval [CI] -9.46, -8.82), with the strongest association observed in the adolescence/adult-exposed group (CE -26.74, 95% CI -27.75, -25.74). Adjusting for variables such as demographics, physical and laboratory tests, complications, and personal habits like smoking and drinking did not qualitatively alter this association (CE -1.38, 95% CI -1.72, -1.04). Further stratification by sex, body mass index, alcohol consumption history, hypertension, diabetes, Center for Epidemiologic Studies Depression score, and education level showed that the association remained consistent. CONCLUSIONS Exposure to famine during different life stages can have enduring effects on GFR decline in humans.
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Affiliation(s)
- Ruichun Meng
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China; Department of Nephrology, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xuefeng Pei
- Department of Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Dongliang Yang
- Department of Mathematics, Cangzhou Medical College, Cangzhou, China
| | - Juanjuan Shang
- Department of Nursing, Cangzhou Medical College, Cangzhou, China
| | - Yangjian Cao
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shengwei Wei
- Department of Urology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
| | - Ye Zhu
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
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Du Y, Luo Y, Nie L, Ren Z, Sun J, Liu J. A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults. Nutrients 2023; 15:4600. [PMID: 37960253 PMCID: PMC10647632 DOI: 10.3390/nu15214600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959-1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963-1965), famine cohorts (1959-1962) were 4.74 times (95% CI = 1.28-8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.
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Affiliation(s)
- Yushan Du
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.D.); (L.N.); (Z.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing 100191, China;
| | - Lirong Nie
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.D.); (L.N.); (Z.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Ziyang Ren
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.D.); (L.N.); (Z.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jinfang Sun
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.D.); (L.N.); (Z.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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Piccoli GB, Torreggiani M, Crochette R, Cabiddu G, Masturzo B, Attini R, Versino E. What a paediatric nephrologist should know about preeclampsia and why it matters. Pediatr Nephrol 2022; 37:1733-1745. [PMID: 34735598 DOI: 10.1007/s00467-021-05235-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 12/24/2022]
Abstract
Preeclampsia is a protean syndrome causing a kidney disease characterised by hypertension and proteinuria, usually considered transitory and reversible after delivery. Its prevalence ranges from 3-5 to 10% if all the related disorders are considered. This narrative review, on behalf of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology, focuses on three reasons why preeclampsia should concern paediatric nephrologists and how they can play an important role in its prevention, as well as in the prevention of future kidney and cardiovascular diseases. Firstly, all diseases of the kidney and urinary tract diagnosed in paediatric age are associated with a higher risk of adverse pregnancy-related outcomes, including preeclampsia. Secondly, babies with low birth weights (small for gestational age, born preterm, or both) have an increased risk of developing the full panoply of metabolic diseases (obesity, hypertension, early-onset cardiopathy and chronic kidney disease) and girls are at higher risk of developing preeclampsia when pregnant. The risk may be particularly high in cases of maternal preeclampsia, highlighting a familial aggregation of this condition. Thirdly, pregnant teenagers have a higher risk of developing preeclampsia and the hypertensive disorders of pregnancy, and should be followed up as high risk pregnancies. In summary, preeclampsia has come to be seen as a window on the future health of both mother and baby. Identification of subjects at risk, early counselling and careful follow-up can contribute to reducing the high morbidity linked with this disorder.
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Affiliation(s)
- Giorgina Barbara Piccoli
- Néphrologie Et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72000, Le Mans, France.
| | - Massimo Torreggiani
- Néphrologie Et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72000, Le Mans, France
| | - Romain Crochette
- Néphrologie Et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72000, Le Mans, France
| | | | - Bianca Masturzo
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, University of Torino, Turin, Italy
| | - Rossella Attini
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, University of Torino, Turin, Italy
| | - Elisabetta Versino
- Epidemiology, Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
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Early-life exposure to the Chinese famine and risk of hyperuricaemia in adult females in Qingdao. Br J Nutr 2022; 127:1639-1646. [PMID: 34284834 DOI: 10.1017/s0007114521002749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two population-based cross-sectional surveys involving randomly selected Chinese adults aged 35-74 years were conducted in Qingdao, China in 2006 and 2009. Nine thousand fifty-five subjects from the two surveys were grouped into four birth groups of fetal/infant exposed (born between 1 January 1959 and 31 December 1962), childhood exposed (born between 1 January 1950 and 31 December 1958), adolescence exposed (born between 1 January 1942 and 31 December 1949) and the unexposed (born before 1941 and after 1963). Multivariate logistic regression models were used to calculate the OR and 95 % CI of hyperuricaemia in different exposed groups. Overall, famine exposure in the fetal/infant period, childhood and adolescence was not associated with adulthood hyperuricaemia (all P > 0·05). In females, childhood exposed group (OR = 1·59, 95 % CI 1·25, 2·02) and adolescence exposed group (OR = 1·74, 95 % CI 1·30, 2·33) both had higher risks to have hyperuricaemia in adult. However, this difference was not found in fetal/infant exposed group. In males, no significant relation was observed in any famine exposed group (all P > 0·05). Exposure to famine in childhood and adolescence is associated with an increased risk of hyperuricaemia for adulthood of females, but not in males. Adequate nutrition during early life appears to be beneficial to prevent hyperuricaemia of adult females.
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DeFreitas MJ, Katsoufis CP, Benny M, Young K, Kulandavelu S, Ahn H, Sfakianaki A, Abitbol CL. Educational Review: The Impact of Perinatal Oxidative Stress on the Developing Kidney. Front Pediatr 2022; 10:853722. [PMID: 35844742 PMCID: PMC9279889 DOI: 10.3389/fped.2022.853722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/13/2022] [Indexed: 01/01/2023] Open
Abstract
Oxidative stress occurs when there is an imbalance between reactive oxygen species/reactive nitrogen species and antioxidant systems. The interplay between these complex processes is crucial for normal pregnancy and fetal development; however, when oxidative stress predominates, pregnancy related complications and adverse fetal programming such as preterm birth ensues. Understanding how oxidative stress negatively impacts outcomes for the maternal-fetal dyad has allowed for the exploration of antioxidant therapies to prevent and/or mitigate disease progression. In the developing kidney, the negative impact of oxidative stress has also been noted as it relates to the development of hypertension and kidney injury mostly in animal models. Clinical research addressing the implications of oxidative stress in the developing kidney is less developed than that of the neurodevelopmental and respiratory conditions of preterm infants and other vulnerable neonatal groups. Efforts to study the oxidative stress pathway along the continuum of the perinatal period using a team science approach can help to understand the multi-organ dysfunction that the maternal-fetal dyad sustains and guide the investigation of antioxidant therapies to ameliorate the global toxicity. This educational review will provide a comprehensive and multidisciplinary perspective on the impact of oxidative stress during the perinatal period in the development of maternal and fetal/neonatal complications, and implications on developmental programming of accelerated aging and cardiovascular and renal disease for a lifetime.
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Affiliation(s)
- Marissa J DeFreitas
- Division of Pediatric Nephrology, Department of Pediatrics, University of Miami, Miami, FL, United States.,Department of Pediatrics, Batchelor Children's Research Institute, University of Miami, Miami, FL, United States
| | - Chryso P Katsoufis
- Division of Pediatric Nephrology, Department of Pediatrics, University of Miami, Miami, FL, United States.,Department of Pediatrics, Batchelor Children's Research Institute, University of Miami, Miami, FL, United States
| | - Merline Benny
- Department of Pediatrics, Batchelor Children's Research Institute, University of Miami, Miami, FL, United States.,Division of Neonatology, Department of Pediatrics, University of Miami, Miami, FL, United States
| | - Karen Young
- Department of Pediatrics, Batchelor Children's Research Institute, University of Miami, Miami, FL, United States.,Division of Neonatology, Department of Pediatrics, University of Miami, Miami, FL, United States
| | - Shathiyah Kulandavelu
- Division of Pediatric Nephrology, Department of Pediatrics, University of Miami, Miami, FL, United States.,Interdisciplinary Stem Cell Institute, University of Miami, Miami, FL, United States
| | - Hyunyoung Ahn
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL, United States
| | - Anna Sfakianaki
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL, United States
| | - Carolyn L Abitbol
- Division of Pediatric Nephrology, Department of Pediatrics, University of Miami, Miami, FL, United States.,Department of Pediatrics, Batchelor Children's Research Institute, University of Miami, Miami, FL, United States
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Abate KH, Abdulahi M, Abdulhay F, Arage G, Mecha M, Yenuss M, Hassen H, Belachew T. Consequences of exposure to prenatal famine on estimated glomerular filtration rate and risk of chronic kidney disease among survivors of the great Ethiopian famine (1983-85): a historical cohort study. Nutr J 2021; 20:19. [PMID: 33653353 PMCID: PMC7927414 DOI: 10.1186/s12937-021-00675-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of an adverse prenatal environment such as famine exposure on the development of adulthood non-communicable chronic illnesses, including diabetes and hypertension has been well articulated in the recent past and supported by evidence. However, there exist few longitudinal studies conducted on the long term consequences of prenatal famine exposure on adulthood kidney function. Hence, we set out to examine whether prenatal exposure to the Ethiopian Great Famine (1983-1985) was associated with changes in estimated glomerular filtration rate (eGFR) and the risk of developing chronic kidney disease (CKD) later in adult life. METHODS The study was conducted in 219 famine exposed and 222 non exposed cohorts in Raya Kobo district, North Wollo Zone, Northern Ethiopia. Estimated GFR was computed from standardized serum creatinine using the CKD Epidemiology Collaboration (CKD-EPI) equation. The definition of CKD includes those with an eGFR of less than 60 ml/min/1.73 m2 on at least in two occasions of 90 days apart (with or without markers of kidney damage). Linear and logistic regression analyses were employed to examine the independent effect of prenatal famine exposure on eGFR and CKD respectively. RESULTS The mean (SD) serum creatinine of exposed and non-exposed groups were 0.78 (0.2) and 0.75 (0.2) respectively. The mean (SD) eGFR of exposed groups was 107.95 (27.49) while the non-exposed 114.48 (24.81) ml/min. In linear regression, the unadjusted model to examine the association between famine exposure and eGFR resulted in a significant negative beta coefficient (β = - 0.124: 95% CI: - 11.43, - 1.64). Adjusting the exposure for outstanding covariates of kidney health, including systolic blood pressure, fasting blood sugar and blood glucose did not alter the inverse relationship (β = -.114 95% CI: - 10.84, - 1.17). In the unadjusted bivariate logistic regression model, famine exposure resulted in nearly 2.7 times higher odds of developing CKD (OR: 2.68, 95% CI: 1.16, 6.2). The odds remained equivalent after adjusting for systolic blood pressure, fasting blood glucose and body mass index (OR = 2.61: 95% CI: 1.120, 6.09). CONCLUSION In the study setting, prenatal exposure to the Great Ethiopian Famine was associated with decreased eGFR and higher risk of developing CKD among survivors. These findings may imply that famine in early life may play a significant role in the development of kidney dysfunction in adulthood.
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Affiliation(s)
- Kalkidan Hassen Abate
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Misra Abdulahi
- Department of Population and Family Heath, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fedlu Abdulhay
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Getachew Arage
- Department of Nutrition and Dietetics, College of Health Sciences, DebreTabor University, Debre Tabor, Ethiopia
| | - Mohammed Mecha
- Department of Internal Medicine, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mohammed Yenuss
- Department of Environmental Health Science, College of Health and Medical Sciences, Wollo University, Dessie, Ethiopia
| | - Habtamu Hassen
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
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Nüsken E, Voggel J, Fink G, Dötsch J, Nüsken KD. Impact of early-life diet on long-term renal health. Mol Cell Pediatr 2020; 7:17. [PMID: 33269431 PMCID: PMC7710776 DOI: 10.1186/s40348-020-00109-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022] Open
Abstract
In the last years, great advances have been made in the effort to understand how nutritional influences can affect long-term renal health. Evidence has accumulated that maternal nutrition before and during pregnancy and lactation as well as early postnatal nutrition is of special significance. In this review, we summarize epidemiologic and experimental data on the renal effects of perinatal exposure to energy restriction, low-protein diet, high-fat diet, high-fructose diet, and high- and low-salt diet as well as micronutrient deficiencies. Interestingly, different modifications during early-life diet may end up with similar sequelae for the offspring. On the other hand, molecular pathways can be influenced in opposite directions by different dietary interventions during early life. Importantly, postnatal nutrition significantly modifies the phenotype induced by maternal diet. Sequelae of altered macro- or micronutrient intakes include altered nephron count, blood pressure dysregulation, altered sodium handling, endothelial dysfunction, inflammation, mitochondrial dysfunction, and oxidative stress. In addition, renal prostaglandin metabolism as well as renal AMPK, mTOR, and PPAR signaling can be affected and the renin-angiotensin-aldosterone system may be dysregulated. Lately, the influence of early-life diet on gut microbiota leading to altered short chain fatty acid profiles has been discussed in the etiology of arterial hypertension. Against this background, the preventive and therapeutic potential of perinatal nutritional interventions regarding kidney disease is an emerging field of research. Especially individuals at risk (e.g., newborns from mothers who suffered from malnutrition during gestation) could disproportionately benefit from well-targeted dietary interventions.
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Affiliation(s)
- Eva Nüsken
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Jenny Voggel
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Gregor Fink
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kai-Dietrich Nüsken
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Wang Y, Weng P, Wan H, Zhang W, Chen C, Chen Y, Cai Y, Guo M, Xia F, Wang N, Lu Y. Economic Status Moderates the Association Between Early-Life Famine Exposure and Hyperuricemia in Adulthood. J Clin Endocrinol Metab 2020; 105:5891935. [PMID: 32789437 DOI: 10.1210/clinem/dgaa523] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/06/2020] [Indexed: 12/12/2022]
Abstract
CONTEXT The double burden of malnutrition (DBM), undernutrition in early life and an obesogenic environment later on, influences later risk of chronic disorders. The Great Famine in China from 1959 to1962 and remarkable economic development from the 1980s provided such a burden for a large number of people in their 60s. OBJECTIVE We aimed to analyze the effect of economic status on the association between famine exposure in early life and hyperuricemia in adulthood. DESIGN AND SETTING Participants numbering 12 666 were enrolled in China based on the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Study from 2014 to 2016. PARTICIPANTS Participants with fetal or childhood famine exposure (birth year 1949-1962) formed the exposure group. MAIN OUTCOME MEASURE Hyperuricemia was defined as uric acid (UA) > 420 μmol/L for men and > 360 μmol/L for women. The association of famine with hyperuricemia was assessed via regression analyses. RESULTS Early-life famine exposure was negatively associated with UA levels (P = .045) but was not associated with hyperuricemia (P = .226) in the whole study population. Economic status could moderate the association of famine exposure with UA and hyperuricemia (P ≤ .001). In participants with high economic status, early-life famine exposure was positively associated with UA levels (unstandardized coefficients 7.61, 95% CI 3.63-11.59, P < .001), and with hyperuricemia (odds ratio 1.47, 95% CI 1.19-1.81, P < .001). CONCLUSIONS Economic status could moderate the association between exposure to famine in early life and hyperuricemia in adulthood, indicating that the DBM might affect hyperuricemia in an opposite direction of the effects of undernutrition in early life alone.
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Affiliation(s)
- Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Pan Weng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yan Cai
- Department of Endocrinology, the Fifth Affiliated Hospital of Kunming Medical University, Yunnan Honghe Prefecture Central Hospital (Ge Jiu People's Hospital), Yunnan, China
| | - Minghao Guo
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Jiang W, Han T, Duan W, Dong Q, Hou W, Wu H, Wang Y, Jiang Z, Pei X, Chen Y, Li Y, Sun C. Prenatal famine exposure and estimated glomerular filtration rate across consecutive generations: association and epigenetic mediation in a population-based cohort study in Suihua China. Aging (Albany NY) 2020; 12:12206-12221. [PMID: 32554859 PMCID: PMC7343514 DOI: 10.18632/aging.103397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022]
Abstract
Prenatal malnutrition could promote renal dysfunction in adulthood, but it is unclear whether the detrimental effect could be transmitted to the next generation. We investigated whether famine exposure was associated with variation of estimated glomerular filtration rate(eGFR) in two generations and explored the mediation role of methylation alterations. The longitudinal analysis included 2909 participants from Suihua rural area. F1 and F2 generations were divided into non-famine and famine group based on their birth year and exposure status of their parents, respectively. The eGFR was calculated by using the chronic kidney disease epidemiology collaboration equation. We applied mixed-effect models to investigate the association between famine and ΔeGFR and tested blood DNA methylomes in 46 families across two generations. The mediation-analysis models were utilized to examine the mediation effect of methylation alterations on the famine-ΔeGFR association. In mixed-effect models, famine exposure was associated with declined ΔeGFR level in F1(β:-8.32;95%CI:-11.51,-5.12) and in F2(β:-6.11;95%CI:-11.88, -0.43). Methylation850K BeadChip data showed only 19 of 961 F1 differentially methylated sites showed concordant alterations in F2. The mediation-analysis results showed methylation alterations on AGTR1 and PRKCA might mediate the famine-ΔeGFR association. Overall, prenatal famine exposure may have long-term effects on eGFR decline across consecutive generations which might be partly mediated by methylation alterations on AGTR1 and PRKCA.
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Affiliation(s)
- Wenbo Jiang
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Tianshu Han
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Wei Duan
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Qiuying Dong
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Wanying Hou
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Huanyu Wu
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Yue Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Zehui Jiang
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Xinyi Pei
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Yingying Chen
- The First Psychiatric Hospital of Harbin, Harbin, Heilongjiang Province 150081, P. R. China
| | - Ying Li
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province 150081, P. R. China
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Torreggiani M, Fois A, D’Alessandro C, Colucci M, Orozco Guillén AO, Cupisti A, Piccoli GB. Of Mice and Men: The Effect of Maternal Protein Restriction on Offspring's Kidney Health. Are Studies on Rodents Applicable to Chronic Kidney Disease Patients? A Narrative Review. Nutrients 2020; 12:E1614. [PMID: 32486266 PMCID: PMC7352514 DOI: 10.3390/nu12061614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022] Open
Abstract
In the almost 30 years that have passed since the postulation of the "Developmental Origins of Health and Disease" theory, it has been clearly demonstrated that a mother's dietary habits during pregnancy have potential consequences for her offspring that go far beyond in utero development. Protein malnutrition during pregnancy, for instance, can cause severe alterations ranging from intrauterine growth retardation to organ damage and increased susceptibility to hypertension, diabetes mellitus, cardiovascular diseases and chronic kidney disease (CKD) later in life both in experimental animals and humans. Conversely, a balanced mild protein restriction in patients affected by CKD has been shown to mitigate the biochemical derangements associated with kidney disease and even slow its progression. The first reports on the management of pregnant CKD women with a moderately protein-restricted plant-based diet appeared in the literature a few years ago. Today, this approach is still being debated, as is the optimal source of protein during gestation in CKD. The aim of this report is to critically review the available literature on the topic, focusing on the similarities and differences between animal and clinical studies.
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Affiliation(s)
- Massimo Torreggiani
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
| | - Antioco Fois
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
| | - Claudia D’Alessandro
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.D.); (A.C.)
| | - Marco Colucci
- Unit of Nephrology and Dialysis, ICS Maugeri S.p.A. SB, Via S. Maugeri 10, 27100 Pavia, Italy;
| | | | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.D.); (A.C.)
| | - Giorgina Barbara Piccoli
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, 10100 Torino, Italy
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12
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Lv S, Shen Z, Zhang H, Yu X, Chen J, Gu Y, Ding X, Zhang X. Association between exposure to the Chinese famine during early life and the risk of chronic kidney disease in adulthood. ENVIRONMENTAL RESEARCH 2020; 184:109312. [PMID: 32151839 DOI: 10.1016/j.envres.2020.109312] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Famine exposure in human early life is proven to be associated with urinary protein concentration and renal function but has not been studied with chronic kidney disease. We aimed to explore the association between exposure to the Chinese famine (from 1959 to 1962) in early life and the risk of chronic kidney disease in adulthood. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS We selected 6267 participants from the baseline survey of China Health and Retirement Longitudinal Study (CHARLS) 2011-2012. Based on the birth year, they were divided into fetal exposed, preschool exposed, school-aged exposed, and non-exposed groups. The estimated glomerular filtration rate (eGFR) was calculated according to Japanese coefficient-modified Chronic Kidney Disease Epidemiology Collaboration equation. Chronic kidney disease (CKD) was defined as eGFR less than 60 mL/min per 1.73 m2. RESULTS The prevalence of CKD in fetal exposed, preschool exposed, school-aged exposed and non-exposed groups was 4.27%, 5.41%, 9.65% and 2.42%, respectively. The risk of CKD in fetal exposed, preschool exposed and school-aged exposed groups was significantly higher than the non-exposed group. In addition, after stratification by gender and famine severity, we found that only fetal exposure to the severe famine was associated with the elevated risk of CKD among male adults (OR 4.44, 95%CI 1.10-17.92, P < 0.05), even after adjusting for age, marital status, household per capita income, history of kidney disease, hypertension, diabetes or abnormal glucose tolerance, smoking, drinking, rural/urban residence and highest educational attainment of parents. CONCLUSIONS Severe famine exposure as a fetus might increase the risk of chronic kidney disease in male adults.
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Affiliation(s)
- Shiqi Lv
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Medical Center of Kidney Disease, Shanghai, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Medical Center of Kidney Disease, Shanghai, China
| | - Han Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Medical Center of Kidney Disease, Shanghai, China
| | - Xixi Yu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Medical Center of Kidney Disease, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yulu Gu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Medical Center of Kidney Disease, Shanghai, China; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China; Shanghai Institute of Kidney and Dialysis, Shanghai, China.
| | - Xiaoyan Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Medical Center of Kidney Disease, Shanghai, China; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China; Shanghai Institute of Kidney and Dialysis, Shanghai, China.
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13
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Li Y, Li Y, Gurol ME, Liu Y, Yang P, Shi J, Zhuang S, Forman MR, Wu S, Gao X. In utero exposure to the Great Chinese Famine and risk of intracerebral hemorrhage in midlife. Neurology 2020; 94:e1996-e2004. [PMID: 32277057 DOI: 10.1212/wnl.0000000000009407] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/15/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate whether in utero exposure to the Great Chinese Famine in 1959 to 1961 was associated with risk of intracerebral hemorrhage (ICH) in adulthood. METHODS In this cohort analysis, we included 97,399 participants of the Kailuan Study who were free of cardiovascular disease and cancer at baseline (2006). Cases of incident ICH were confirmed by medical record review. We used the Cox proportional hazards model to calculate the hazard ratio (HR) and 95% confidence interval (CI) for ICH according to in utero famine exposure status. RESULTS Among 97,399 participants in the current analyses, 6.3% (n = 6,160) had been prenatally exposed to the Great Chinese Famine. During a median 9.0 years of follow-up (2006-2015), we identified 724 cases of incident ICH. After adjustment for potential confounders, the HR of ICH was 1.99 (95% CI 1.39-2.85) for in utero famine-exposed individuals vs individuals who were not exposed to the famine. When exposure to famine and severity of famine were examined jointly, the adjusted HR was 2.99 (95% CI 1.21-7.39) for in utero exposure to severe famine and 1.94 (95% CI 1.32-2.84) for in utero exposure to less severe famine relative to those without exposure to famine. CONCLUSIONS Individuals with in utero exposure to famine, especially those exposed to severe famine, were more likely to have ICH in midlife, highlighting the role of nutritional factors in susceptibility to this severe cerebral condition.
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Affiliation(s)
- Yun Li
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Yanping Li
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - M Edip Gurol
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Yesong Liu
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Peng Yang
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Jihong Shi
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Sheng Zhuang
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Michele R Forman
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN
| | - Shouling Wu
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN.
| | - Xiang Gao
- From the Department of Preventive Medicine (Yun Li), School of Public Health, North China University of Science and Technology, Tangshan; Department of Nutritional Sciences (Yun Li, X.G.), Pennsylvania State University, State College; Department of Nutrition (Yanping Li), Harvard T.H. Chan School of Public Health; Department of Neurology (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Neurology (Y. Liu) and Cardiology (J.S., S.W.), Kailuan General Hospital, North China University of Science and Technology; Department of Neurosurgery (P.Y.), Affiliated Hospital of North China University of Science and Technology, Tangshan; Department of Neurology (S.Z.), The Second Affiliated Hospital of Soochow University, Suzhou, China; and Department of Nutrition Science (M.R.F.), Purdue University, West Lafayette, IN.
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Lee YQ, Beckett EL, Sculley DV, Rae KM, Collins CE, Pringle KG. Relationship between maternal global nutrient restriction during pregnancy and offspring kidney structure and function: a systematic review of animal studies. Am J Physiol Renal Physiol 2019; 316:F1227-F1235. [DOI: 10.1152/ajprenal.00082.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Maternal undernutrition during pregnancy is prevalent across the globe, and the origins of many chronic diseases can be traced back to in utero conditions. This systematic review considers the current evidence in animal models regarding the relationship between maternal global nutrient restriction during pregnancy and offspring kidney structure and function. CINAHL, Cochrane, EMBASE, MEDLINE, and Scopus were searched to November 2017. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed, and articles were screened by two independent reviewers. Twenty-eight studies met the inclusion criteria: 16 studies were on rats, 9 on sheep, 2 on baboons, and 1 on goats. The majority of the rat studies had maternal global nutrient restriction during pregnancy at 50% of ad libitum while restriction for sheep and baboon studies ranged from 50% to 75%. Because of the heterogeneity of outcome measures and the large variation in the age of offspring at followup, no meta-analysis was possible. Common outcome measures included kidney weight, nephron number, glomerular size, glomerular filtration rate, and creatinine clearance. To date, there have been no studies assessing kidney function in large animal models. Most studies were rated as having a high or unknown risk of bias. The current body of evidence in animals suggests that exposure to maternal global nutrient restriction during pregnancy has detrimental effects on offspring kidney structure and function, such as lower kidney weight, lower nephron endowment, larger glomerular size, and lower glomerular filtration rate. Further long-term followup of studies in large animal models investigating kidney function through to adulthood are warranted.
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Affiliation(s)
- Yu Qi Lee
- Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
| | - Emma L. Beckett
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Dean V. Sculley
- Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kym M. Rae
- Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health and Medicine, Gomeroi Gaaynggal Center, University of Newcastle, Tamworth, New South Wales, Australia
- Department of Rural Health, University of Newcastle, Tamworth, New South Wales, Australia
- Priority Research Center for Generational Health and Aging, University of Newcastle, Newcastle, New South Wales, Australia
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kirsty G. Pringle
- Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Faculty of Health and Medicine, Gomeroi Gaaynggal Center, University of Newcastle, Tamworth, New South Wales, Australia
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Prenatal war exposure and schizophrenia in adulthood: evidence from the Sino-Japanese War of 1937-1945. Soc Psychiatry Psychiatr Epidemiol 2019; 54:313-320. [PMID: 30269260 DOI: 10.1007/s00127-018-1584-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/20/2018] [Indexed: 01/27/2023]
Abstract
PURPOSE This study aimed to examine the long-term effect of prenatal exposure to the Sino-Japanese War during 1937-1945 on risk of schizophrenia in adulthood among Chinese wartime survivors. METHODS We obtained data from the Second National Sample Survey on Disability conducted in 31 provinces in 2006. We restricted our analysis to 369,469 adults born between 1931 and 1950. Schizophrenia was ascertained by psychiatrists based on the International Statistical Classification of Diseases 10th Revision. War intensity was assessed by the ratio of war-caused civilian casualties to the pre-war population. The effect of prenatal exposure to war on schizophrenia was estimated by difference-in-difference models, established by examining the variation of war across birth cohorts. RESULTS In the male population, war cohorts of 1937-1946 had no significant higher odds of schizophrenia compared with the pre-war cohorts of 1931-1936. In the female population, war cohorts were 1.16 (95% CI 1.01, 1.33) times more likely than pre-war cohorts to have schizophrenia. Sensitive analyses show that our estimates of war effect on schizophrenia were robust and valid. CONCLUSIONS Prenatal exposure to the Sino-Japanese War of 1937-1945 had long-run detrimental effect on risk of schizophrenia in the female adults. Further investigations are warranted to extend the enduring wartime impact on other health outcomes in China.
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16
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The effect of Chinese famine exposure in early life on dietary patterns and chronic diseases of adults. Public Health Nutr 2018; 22:603-613. [PMID: 30526705 DOI: 10.1017/s1368980018003440] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the effect of famine exposure during early life on dietary patterns, chronic diseases, and the interaction effect between famine exposure and dietary patterns on chronic diseases in adulthood. DESIGN Cross-sectional study. Dietary patterns were derived by factor analysis. Multivariate quantile regression and log-binomial regression were used to evaluate the impact of famine exposure on dietary patterns, chronic diseases and the interaction effect between famine exposure and dietary patterns on chronic diseases, respectively. SETTING Hefei, China. PARTICIPANTS Adults aged 45-60 years (n 939). RESULTS 'Healthy', 'high-fat and high-salt', 'Western' and 'traditional Chinese' dietary patterns were identified. Early-childhood and mid-childhood famine exposure were remarkably correlated with high intake of the traditional Chinese dietary pattern. Compared with the non-exposed group (prevalence ratio (PR); 95 % CI), early-childhood (3·13; 1·43, 6·84) and mid-childhood (2·37; 1·05, 5·36) exposed groups showed an increased PR for diabetes, and the early-childhood (2·07; 1·01, 4·25) exposed group showed an increased PR for hypercholesterolaemia. Additionally, relative to the combination of non-exposed group and low-dichotomous high-fat and high-salt dietary pattern, the combination of famine exposure in early life and high-dichotomous high-fat and high-salt dietary pattern in adulthood had higher PR for diabetes (4·95; 1·66, 9·05) and hypercholesterolaemia (3·71; 1·73, 7·60), and significant additive interactions were observed. CONCLUSIONS Having suffered the Chinese famine in childhood might affect an individual's dietary habits and health status, and the joint effect between famine and harmful dietary pattern could have serious consequences on later-life health outcomes.
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Li C, Miles T, Shen L, Shen Y, Liu T, Li S, Huang C, Huang C. Early-life exposure to severe famine and subsequent risk of depressive symptoms in late adulthood: the China Health and Retirement Longitudinal Study. Br J Psychiatry 2018; 213:579-586. [PMID: 30160644 PMCID: PMC6815226 DOI: 10.1192/bjp.2018.116] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Chinese Great Famine caused widespread starvation in 1959-1961. Its long-term association with depressive symptoms has not been studied.AimsTo estimate the burden of depressive symptoms and the association of famine exposure with depressive symptoms. METHOD The China Health and Retirement Longitudinal Study is a nationwide representative survey of 17 708 Chinese adults aged ≥45. Propensity score matching and modified Poisson regression were used to evaluate the association between self-reported famine exposure in early life and depressive symptoms among the overall participants. Such associations were also assessed by developmental stage using modified Poisson regression and logistic regression. RESULTS The prevalence of depressive symptoms was 26.2% (95% CI 25.1-27.3%) in 2011. As defined by loss of family members because of starvation, 11.6% (95% CI 10.1-13.1%) of this population experienced severe famine. When compared with participants who did not experience starvation, those who had experienced severe famine during fetal, mid-childhood, young-teenage and early-adulthood stages had 1.87 (95% CI 1.36-2.55), 1.54 (95% CI 1.23-1.94), 1.47 (95% CI 1.09-2.00) and 1.77 (95% CI 1.42-2.21) times higher odds of having depressive symptoms in late adulthood, respectively. The first two trimesters of pregnancy were a critical time window during the fetal stage when severe famine had a stronger association with depressive symptoms. Famine during infant, toddler, preschool or teenage stages was not associated with depressive symptoms. Overall, famine contributed to 13.6% of the depressive symptom burden in this population. CONCLUSIONS The Chinese Great Famine contributed substantially to the burden of depressive symptoms in China.Declaration of interestNone.
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Affiliation(s)
- Changwei Li
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, 101 Buck Rd, Athens, GA 30602, USA,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street Suite 2000, New Orleans, LA 70112, USA
| | - Toni Miles
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, 101 Buck Rd, Athens, GA 30602, USA
| | - Luqi Shen
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, 101 Buck Rd, Athens, GA 30602, USA
| | - Ye Shen
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, 101 Buck Rd, Athens, GA 30602, USA
| | - Tingting Liu
- Department of Nursing, University of Arkansas College of Education and Health Professions
| | - Shengxu Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street Suite 2000, New Orleans, LA 70112, USA
| | - Cheng Huang
- School of Economics and Management, Harbin Institute of Technology (Shenzhen), Building E Room 412, Nanshan District, Shenzhen 518055, Guangdong, China,Department of Global Health, George Washington University Milken Institute School of Public Health, 2175K Street, Suite 200, Washington, DC 20037, USA
| | - Cheng Huang
- Professor of Health Economics, School of Economics and Management,Harbin Institute of Technology (Shenzhen),China and Department of Global Health,George Washington University,USA
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18
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Li C, Lumey LH. Exposure to the Chinese famine of 1959-61 in early life and long-term health conditions: a systematic review and meta-analysis. Int J Epidemiol 2018; 46:1157-1170. [PMID: 28338900 DOI: 10.1093/ije/dyx013] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2017] [Indexed: 01/19/2023] Open
Abstract
Background Most Chinese people over 55 years old today have experienced the Great Leap Forward Famine of 1959-61. Many reports suggested that the famine could have profound long-term health effects for exposed birth cohorts. A systematic review and meta-analysis was carried out to summarize reported famine effects on long-term health. Methods Relevant reports were identified by searching PubMed, Embase, Chinese Wanfang Data and Chinese National Knowledge Infrastructure databases. Long-term health conditions were compared in exposed birth cohorts and unexposed controls. Fixed-effects models and random-effects models were used to combine results on adult overweight, obesity, type 2 diabetes, hyperglycaemia, hypertension, the metabolic syndrome and schizophrenia. The heterogeneity across reports was assessed. Subgroup analyses were carried out using reported famine severity, provincial mortality during famine, sex and other report characteristics. Results In all, 36 reports were eligible for systematic review and 21 could be used for meta-analysis. The number of events we analysed ranged from 1029 for hyperglycaemia to 8973 for hypertension. As reported by others, overweight, type 2 diabetes, hyperglycaemia, the metabolic syndrome, and schizophrenia were more common among adults born during the famine compared with controls born after the famine. By contrast, there were no increases in overweight [odds ratio (OR) 0.68; 95% confidence interval (CI): 0.27-1.72], type 2 diabetes (OR 0.96; 95% CI: 0.73-1.28), hyperglycaemia (OR 0.99; 95% CI: 0.72-1.36) or the metabolic syndrome (OR 1.11; 95% CI: 1.00-1.22) comparing adults born during the famine with controls born either after or before the famine. For schizophrenia, the effect estimates (OR 1.60; 95% CI: 1.50-1.70, combining control groups) were similar in the two scenarios. Conclusions Our findings suggest that uncontrolled age differences between famine and post-famine births could explain most effects commonly attributed to the famine. For more reliable estimates of long-term famine effects in China, other analyses will be needed with age-appropriate controls and better information on the severity and timing of the famine in the populations included.
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Affiliation(s)
- Chihua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - L H Lumey
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Prenatal malnutrition and adult cognitive impairment: a natural experiment from the 1959-1961 Chinese famine. Br J Nutr 2018; 120:198-203. [PMID: 29720288 DOI: 10.1017/s0007114518000958] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The current measures of cognitive functioning in adulthood do not indicate a long-term association with prenatal exposure to the Dutch famine. However, whether such association emerges in China is poorly understood. We aimed to investigate the potential effect of prenatal exposure to the 1959-1961 Chinese famine on adult cognitive impairment. We obtained data from the Second National Sample Survey on Disability implemented in thirty-one provinces in 2006, and restricted our analysis to 387 093 individuals born in 1956-1965. Cognitive impairment was defined as intelligence quotient (IQ) score under 70 and IQ of adults was evaluated by the Wechsler Adult Intelligence Scale - China Revision. Famine severity was defined as excess death rate. The famine impact on adult cognitive impairment was estimated by difference-in-difference models, established by examining the variations of famine exposure across birth cohorts. Results show that compared with adults born in 1956-1958, those who were exposed to Chinese famine during gestation (born in 1959-1961) were at greater risk of cognitive impairment in the total sample. Stratified analyses showed that this effect was evident in males and females, but only in rural, not in urban areas. In conclusion, prenatal exposure to famine had an enduring deleterious effect on risk of cognitive impairment in rural adults.
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20
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Moraru A, de Almeida MM, Degryse JM. PALTEM: What Parameters Should Be Collected in Disaster Settings to Assess the Long-Term Outcomes of Famine? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050857. [PMID: 29693637 PMCID: PMC5981896 DOI: 10.3390/ijerph15050857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/14/2018] [Accepted: 04/21/2018] [Indexed: 12/18/2022]
Abstract
Evidence suggests that nutritional status during fetal development and early life leaves an imprint on the genome, which leads to health outcomes not only on a person as an adult but also on his offspring. The purpose of this study is to bring forth an overview of the relevant parameters that need to be collected to assess the long-term and transgenerational health outcomes of famine. A literature search was conducted for the most pertinent articles on the epigenetic effects of famine. The results were compiled, synthesized and discussed with an expert in genetics for critical input and validation. Prenatal and early life exposure to famine was associated with metabolic, cardiovascular, respiratory, reproductive, neuropsychiatric and oncologic diseases. We propose a set of parameters to be collected in disaster settings to assess the long-term outcomes of famine: PALTEM (parameters to assess long-term effects of malnutrition).
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Affiliation(s)
- Alexandra Moraru
- Centre for Research on the Epidemiology of Disasters, Université Catholique de Louvain, Brussels 1200, Belgium.
| | - Maria Moitinho de Almeida
- Centre for Research on the Epidemiology of Disasters, Université Catholique de Louvain, Brussels 1200, Belgium.
| | - Jean-Marie Degryse
- Institute of Health and Society, Université Catholique de Louvain, Brussels 1200, Belgium.
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven 3000, Belgium.
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21
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He P, Chen G, Guo C, Wen X, Song X, Zheng X. Long-term effect of prenatal exposure to malnutrition on risk of schizophrenia in adulthood: Evidence from the Chinese famine of 1959-1961. Eur Psychiatry 2018. [PMID: 29514118 DOI: 10.1016/j.eurpsy.2018.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Schizophrenia is a common major mental disorder and prenatal nutritional deficiency may increase its risk. We aimed to investigate long-term impact of prenatal exposure to malnutrition on risk of schizophrenia in adulthood using the Chinese famine of 1959-1961 as a natural experiment. METHODS We obtained data from the Second National Sample Survey on Disability implemented in 31 provinces in 2006, and restricted our analysis to 387,093 individuals born from 1956 to 1965. Schizophrenia was ascertained by psychiatrists based on the International Statistical Classification of Diseases, Tenth Revision. Famine severity was defined as cohort size shrinkage index. The famine effect on adult schizophrenia was estimated by difference-in-difference models, established by examining the variations of famine exposure across birth cohorts. RESULTS Compared with the reference cohort of 1965, famine cohorts (1959-1962) had significantly higher odds (OR: 1.84; 95% CI: 1.13, 3.00; P = 0.014) of schizophrenia in the rural population. After adjusting for multiple covariates, this association remained significant (OR: 1.82; 95% CI: 1.11, 2.98; P = 0.018). We did not observe statistically significant differences in odds of schizophrenia among famine cohorts compared with the reference cohort in the urban population. CONCLUSIONS Prenatal malnutrition exposure has a detrimental impact on risk of schizophrenia in adulthood in the rural population. Further studies were needed to investigate corresponding mechanisms on this topic.
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Affiliation(s)
- Ping He
- China Center for Health Development Studies, Peking University, Beijing, China; Institute of Population Research, Peking University, Beijing, China; Bloomberg School of Public Health, Johns Hopkins University, MD, United States
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China; APEC Health Science Academy (HeSAY), Peking University, Beijing, China
| | - Xu Wen
- Institute of Population Research, Peking University, Beijing, China
| | - Xinming Song
- Institute of Population Research, Peking University, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing, China; APEC Health Science Academy (HeSAY), Peking University, Beijing, China.
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Lee YQ, Collins CE, Gordon A, Rae KM, Pringle KG. The Relationship between Maternal Nutrition during Pregnancy and Offspring Kidney Structure and Function in Humans: A Systematic Review. Nutrients 2018; 10:nu10020241. [PMID: 29466283 PMCID: PMC5852817 DOI: 10.3390/nu10020241] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 12/30/2022] Open
Abstract
The intrauterine environment is critical for fetal growth and organ development. Evidence from animal models indicates that the developing kidney is vulnerable to suboptimal maternal nutrition and changes in health status. However, evidence from human studies are yet to be synthesised. Therefore, the aim of the current study was to systematically review current research on the relationship between maternal nutrition during pregnancy and offspring kidney structure and function in humans. A search of five databases identified 9501 articles, of which three experimental and seven observational studies met the inclusion criteria. Nutrients reviewed to date included vitamin A (n = 3), folate and vitamin B12 (n = 2), iron (n = 1), vitamin D (n = 1), total energy (n = 2) and protein (n = 1). Seven studies were assessed as being of "positive" and three of "neutral" quality. A variety of populations were studied, with limited studies investigating maternal nutrition during pregnancy, while measurements of offspring kidney outcomes were diverse across studies. There was a lack of consistency in the timing of follow-up for offspring kidney structure and/or function assessments, thus limiting comparability between studies. Deficiencies in maternal folate, vitamin A, and total energy during pregnancy were associated with detrimental impacts on kidney structure and function, measured by kidney volume, proteinuria, eGFRcystC and mean creatinine clearance in the offspring. Additional experimental and longitudinal prospective studies are warranted to confirm this relationship, especially in Indigenous populations where the risk of renal disease is greater.
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Affiliation(s)
- Yu Qi Lee
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Adrienne Gordon
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia.
| | - Kym M Rae
- Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, NSW 2308, Australia.
- Gomeroi Gaaynggal Centre, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW 2340, Australia.
- Department of Rural Health, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW 2340, Australia.
- Priority Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Kirsty G Pringle
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, NSW 2308, Australia.
- Gomeroi Gaaynggal Centre, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW 2340, Australia.
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Wang N, Ning Z, Xia F, Chen C, Cheng J, Chen Y, Lu Y. Exposure to famine in early life and chronic kidney diseases in adulthood. Nutr Diabetes 2018; 8:4. [PMID: 29335447 PMCID: PMC5851427 DOI: 10.1038/s41387-017-0014-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/01/2017] [Accepted: 11/14/2017] [Indexed: 12/19/2022] Open
Abstract
Objective Chronic kidney disease (CKD) is an increasing contributor to the global disease burden. Previous findings indicated that exposure to famine in early life was associated with various metabolic diseases and urinary protein levels. We aimed to assess whether the exposure to China’s Great Famine 1959–1962 during fetal or childhood period was associated with glomerular filtration rate (GFR) and risk of CKD (eGFR<60 mL/min per 1.73 m2) in adulthood. Materials and methods SPECT-China was a population-based observational study in 2014–2015. Totally, 5124 women were included from SPECT-China study. Based on the birth year, they were divided into fetal-exposed (1959–1962), childhood-exposed (1949–1958), adolescence/young adult-exposed (1921–1948), and non-exposed (1963–1974, reference). The estimated glomerular filtration rate (eGFR) was calculated according to the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined as eGFR less than 60 mL/min per 1.73 m2. Results Compared with the non-exposed, fetal exposure to famine was significantly associated with lower eGFR (B −1.47, 95%CI −2.81, −1.13) and greater risk of having CKD (OR 2.85, 95%CI 1.25, 6.50) in the crude model adjusting age. Further adjustments for demographic variables, body mass index, diabetes, and blood pressure did not qualitatively change the association (eGFR B −1.35, 95%CI −2.67, −0.04; CKD OR 2.42, 95%CI 1.05, 5.58). This association was not found in childhood-exposed and adolescence/young adult-exposed individuals. Conclusions Prenatal exposure to famine may have long-term effects on declined GFR and the development of CKD in humans. thus, fetal stage may be an important time window to prevent CKD in later life.
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Affiliation(s)
- Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhiyuan Ning
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jing Cheng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | | | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Abstract
Chronic kidney disease affects more than 10% of the population. Programming studies have examined the interrelationship between environmental factors in early life and differences in morbidity and mortality between individuals. A number of important principles has been identified, namely permanent structural modifications of organs and cells, long-lasting adjustments of endocrine regulatory circuits, as well as altered gene transcription. Risk factors include intrauterine deficiencies by disturbed placental function or maternal malnutrition, prematurity, intrauterine and postnatal stress, intrauterine and postnatal overnutrition, as well as dietary dysbalances in postnatal life. This mini-review discusses critical developmental periods and long-term sequelae of renal programming in humans and presents studies examining the underlying mechanisms as well as interventional approaches to "re-program" renal susceptibility toward disease. Clinical manifestations of programmed kidney disease include arterial hypertension, proteinuria, aggravation of inflammatory glomerular disease, and loss of kidney function. Nephron number, regulation of the renin-angiotensin-aldosterone system, renal sodium transport, vasomotor and endothelial function, myogenic response, and tubuloglomerular feedback have been identified as being vulnerable to environmental factors. Oxidative stress levels, metabolic pathways, including insulin, leptin, steroids, and arachidonic acid, DNA methylation, and histone configuration may be significantly altered by adverse environmental conditions. Studies on re-programming interventions focused on dietary or anti-oxidative approaches so far. Further studies that broaden our understanding of renal programming mechanisms are needed to ultimately develop preventive strategies. Targeted re-programming interventions in animal models focusing on known mechanisms will contribute to new concepts which finally will have to be translated to human application. Early nutritional concepts with specific modifications in macro- or micronutrients are among the most promising approaches to improve future renal health.
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Affiliation(s)
- Eva Nüsken
- Pediatric Nephrology, Department of Pediatrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jörg Dötsch
- Pediatric Nephrology, Department of Pediatrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Lutz T Weber
- Pediatric Nephrology, Department of Pediatrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kai-Dietrich Nüsken
- Pediatric Nephrology, Department of Pediatrics, Medical Faculty, University of Cologne, Cologne, Germany
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25
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Liu L, Xu X, Zeng H, Zhang Y, Shi Z, Zhang F, Cao X, Xie YJ, Reis C, Zhao Y. Increase in the prevalence of hypertension among adults exposed to the Great Chinese Famine during early life. Environ Health Prev Med 2017; 22:64. [PMID: 29165159 PMCID: PMC5664831 DOI: 10.1186/s12199-017-0671-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/15/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to assess the association between exposure to the Great Chinese Famine (1959-1961) during early life and hypertension in adulthood. METHODS From July to September 2009, 1224 eligible adults were recruited in a cross-sectional survey using a multi-stage stratified random sampling method in Chongqing China. A questionnaire was used to collect information of hypertension and sociodemographic factors. Participants were categorized as childhood, fetal, and none exposure to famine based on the date of birth. RESULTS Of the sample, 12.3% reported having hypertension. The prevalence of hypertension varied by famine status: 11.9% in childhood exposure, 16.1% in fetal exposure, and 10.2% in non-exposure group. After adjusting for sociodemographic and lifestyle factors, compared with non-exposure group, fetal exposure group had an increased likelihood of having hypertension with odds ratio of 1.79 (95%CI 1.13-2.84). Although there was no significant gender and famine interaction, the positive association between famine exposure and hypertension was stronger among women than men. CONCLUSION Fetal exposure to the Chinese famine may be associated with an increased risk of hypertension in adulthood in women [corrected].
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Affiliation(s)
- Lingli Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Huan Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yong Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Zumin Shi
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia
| | - Fan Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xianqing Cao
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong, Special Administrative Region of China
| | - Cesar Reis
- Department of Preventive Medicine, Loma Linda University Medical Center, 24785 Stewart Street, Suite 204, Loma Linda, CA, 92354, USA
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China. .,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China. .,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
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26
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Self-reported sleep duration and daytime napping are associated with renal hyperfiltration in general population. Sleep Breath 2017; 22:223-232. [DOI: 10.1007/s11325-017-1470-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/20/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
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27
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Alcohol consumption and the risk for renal hyperfiltration in the general Chinese population. Eur J Clin Nutr 2016; 71:500-505. [DOI: 10.1038/ejcn.2016.168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/19/2016] [Accepted: 07/25/2016] [Indexed: 01/21/2023]
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