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He SY, Zhang WS, Jiang CQ, Jin YL, Lam TH, Cheng KK, Xu L. Association of adverse childhood experiences with anemia in older Chinese: Guangzhou Biobank Cohort Study. Sci Rep 2024; 14:4729. [PMID: 38413624 PMCID: PMC10899217 DOI: 10.1038/s41598-024-54378-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
To examine the association of adverse childhood experiences (ACEs) with anemia among older people. 24,116 participants aged 50 years or above were recruited. Multivariable linear and logistic regression was used to assess the associations of self-reported ACEs number with hemoglobin concentrations (g/dL) and presence of anemia. Older individuals with two or more ACEs, versus no ACEs, showed lower hemoglobin concentrations (β = - 0.08 g/dL, 95% confidence intervals (CI) - 0.12 to - 0.03) and higher odds of anemia (odds ratio = 1.26, 95% CI 1.01-1.59). A more pronounced association between ACEs and anemia in the lower education group was found, while the association became non-significant in those with higher education (P for ACEs-education interaction = 0.02). ACEs was associated with anemia in older people, and the association was stronger in those with lower education, highlighting the significance of early-life psychological stressors assessment and consideration of education background in geriatric care.
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Affiliation(s)
- Shao Yi He
- School of Public Health, Sun Yat-Sen University, No. 74, 2nd Zhongshan Road, Guangzhou, Guangdong, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China.
| | - Chao Qiang Jiang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-Sen University, No. 74, 2nd Zhongshan Road, Guangzhou, Guangdong, China.
- School of Public Health, The University of Hong Kong, Hong Kong, China.
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China.
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2
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Smagulova F. [Multigenerational epigenetic inheritance in human: the past, present and perspectives]. Biol Aujourdhui 2023; 217:233-243. [PMID: 38018951 DOI: 10.1051/jbio/2023032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Indexed: 11/30/2023]
Abstract
Nowadays, a growing body of evidence suggests that the developmental programs of each individual could be modified. The acquired new phenotypic changes could be persistent throughout the individual's life and even transmitted to the next generation. While the exact mechanism for that preservation is not well understood yet, there are many evidences showing that epigenetic alterations, which are robust and dynamic in response to the influence of the environmental factors, could be responsible for that inheritance. A growing number of external factors such as social stress, environmental pollution and climate changes make adaptation to these environmental changes rather challenging. According to the Developmental Origin of Human Disease theory, formulated by David Barker, environmental conditions experienced during the first phases of development can have long term effects on later phases of life. This phenomenon is linked to the biological plasticity of development, which allows reprogramming of physiological functions in response to different stimuli. Consequently, in utero exposure to environmental pollutants can increase predisposition to different pathologies that can occur both in early and later phases of life not only in the living generation but also in subsequent ones. Here, we have summarised some findings in human epigenetic research studies performed for the past few years which address the question whether transgenerational effects observed in model organisms could also occur in humans.
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Affiliation(s)
- Fatima Smagulova
- Univ. Rennes, EHESP, Inserm, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 9 avenue Léon Bernard, 35000 Rennes, France
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3
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Bedha A, Shindano T, Hermans MP, Havelange V, Makali S, Minani J, Ngaboyeka G, Kunaba E, Donnen P, Dramaix M, Bisimwa G, Mwene-Batu P. Association between severe acute malnutrition in childhood and hematological disorders in adulthood: the Lwiro follow-up study in the Eastern Democratic Republic of the Congo. BMC Nutr 2023; 9:128. [PMID: 37951995 PMCID: PMC10638766 DOI: 10.1186/s40795-023-00783-0] [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: 01/29/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Despite growing evidence on the short-term deleterious effects of severe acute malnutrition (SAM) in childhood on hematopoiesis, little is known about the long-term hematological effects of SAM in low-income countries (LICs). Our study explored the association between childhood SAM and hematological disorders in adults 11 to 30 years after post-SAM nutritional rehabilitation. METHODS This follow up study investigated 97 adults (mean age 32 years) treated for SAM during childhood in eastern Democratic Republic of the Congo (DRC) between 1988 and 2007. Participants were compared to 97 aged- and sex-matched adult controls living in the same community with no history of SAM. Outcomes of interest were hematological characteristics and disorders in adulthood, assessed by various biological markers. Logistic and linear regression models were used to estimate the association between SAM in childhood and risk of hematological abnormalities. RESULTS Compared to the unexposed, the exposed had higher mean white blood cells (/μl) [+ 840 (179 to 1501), p = 0.013], neutrophils [+ 504 (83 to 925), p = 0.019] and platelets (*103) [11.9 (8.1 to 17.9), p = 0.038] even after adjustment for food consumption in adulthood. No difference was observed in red blood cells (RBC), hemoglobin and erythrocytes parameters. With regard to the risk of hematological disorders, in contrast to the unexposed, exposed subjects had a risk of leukocytosis approximately three times higher [adjusted OR (95% CI): 2.98 (1.01 to 8.79), p = 0.048]. No difference was observed in terms of anemia, leukopenia, increased platelets and thrombocytopenia between the 2 groups. CONCLUSION Adults with a history of SAM in childhood have hematological characteristics that would be markers associated with chronic low-grade inflammatory or infectious diseases in an environment with no nutritional transition. Larger cohort studies with bone marrow analyses could provide further understanding of the impact of SAM on the overall hematological profile in adult life.
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Affiliation(s)
- Aline Bedha
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Tony Shindano
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Michel P Hermans
- Division of Endocrinology & Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Violaine Havelange
- Services d'hématologie, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Samuel Makali
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Jimmy Minani
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Gaylord Ngaboyeka
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Edwige Kunaba
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Philippe Donnen
- Ecole de Santé Publique, Université Libre de Bruxelles, 1070, Brussels, Belgium
| | - Michelle Dramaix
- Ecole de Santé Publique, Université Libre de Bruxelles, 1070, Brussels, Belgium
| | - Ghislain Bisimwa
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Pacifique Mwene-Batu
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo.
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo.
- Faculté de Médecine, Université de Kaziba, Kaziba, Democratic Republic of the Congo.
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4
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Huo W, Hou J, Nie L, Mao Z, Liu X, Chen G, Xiang H, Li S, Guo Y, Wang C. Combined effects of air pollution in adulthood and famine exposure in early life on type 2 diabetes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:37700-37711. [PMID: 35066828 DOI: 10.1007/s11356-021-18193-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Famine exposure or air pollution is linked to type 2 diabetes mellitus (T2DM). However, their combined effects on T2DM remain largely unknown. A total of 11,640 individuals were obtained from the Henan Rural Cohort Study. According to their birthdate, participants were divided into three famine exposure subgroups: fetal exposed, childhood exposed, and unexposed groups. The air pollutants (particles with aerodynamics diameters ≤ 1.0 µm (PM1), ≤ 2.5 µm, and ≤ 10 µm, and nitrogen dioxide) concentrations of each individual were estimated by a spatiotemporal model. Participants were divided into low or high air pollution exposure groups taking the 1st quartile value of air pollutants as the cut-off point. Logistic regression model was used to analyze independent and joint associations between air pollution exposure, famine exposure, and T2DM. Positive associations of air pollution and famine exposure with T2DM were found. Participants who experienced fetal or childhood famine and also were exposed to high concentrations of any kind of the air pollutants had a much higher risk for T2DM than those with no famine and low air pollutants exposure (taking PM1.0 for example, the odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.25, 2.47 for fetal famine, and OR: 1.64, 95%CI: 1.13, 2.40 for childhood famine). After stratified analysis, similar results were observed in women. The results indicated that both famine exposure in early life and air pollution exposure in adulthood are related to increased risk for prevalent T2DM, and they have combined effects on T2DM.
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Affiliation(s)
- Wenqian Huo
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China
| | - Luting Nie
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, PR China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China.
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5
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Vasishta S, Umakanth S, Adiga P, Joshi MB. Extrinsic and intrinsic factors influencing metabolic memory in type 2 diabetes. Vascul Pharmacol 2021; 142:106933. [PMID: 34763098 DOI: 10.1016/j.vph.2021.106933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/18/2021] [Accepted: 11/04/2021] [Indexed: 12/24/2022]
Abstract
Direct and indirect influence of pathological conditions in Type 2 Diabetes (T2D) on vasculature manifests in micro and/or macro vascular complications that act as a major source of morbidity and mortality. Although preventive therapies exist to control hyperglycemia, diabetic subjects are always at risk to accrue vascular complications. One of the hypotheses explained is 'glycemic' or 'metabolic' memory, a process of permanent epigenetic change in different cell types whereby diabetes associated vascular complications continue despite glycemic control by antidiabetic drugs. Epigenetic mechanisms including DNA methylation possess a strong influence on the association between environment and gene expression, thus indicating its importance in the pathogenesis of a complex disease such as T2D. The vascular system is more prone to environmental influences and present high flexibility in response to physiological and pathological challenges. DNA methylation based epigenetic changes during metabolic memory are influenced by sustained hyperglycemia, inflammatory mediators, gut microbiome composition, lifestyle modifications and gene-nutrient interactions. Hence, understanding underlying mechanisms in manifesting vascular complications regulated by DNA methylation is of high clinical importance. The review provides an insight into various extrinsic and intrinsic factors influencing the regulation of DNA methyltransferases contributing to the pathogenesis of vascular complications during T2D.
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Affiliation(s)
- Sampara Vasishta
- Department of Ageing Research, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Shashikiran Umakanth
- Department of Medicine, Dr. T.M.A. Pai Hospital, Manipal Academy of Higher Education, Udupi 576101, Karnataka, India
| | - Prashanth Adiga
- Department of Reproductive Medicine and Surgery (MARC), Kasturba Hospital, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Manjunath B Joshi
- Department of Ageing Research, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
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6
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Suo Y, Chen W, Pan Y, Li H, Meng X, Li Z, Wang C, Jing J, Wang Y, Wang Y. Concurrency of Early-Age Exposure to Chinese Famine and Diabetes Increases Recurrence of Ischemic Stroke. Front Neurol 2021; 11:520633. [PMID: 33551946 PMCID: PMC7855705 DOI: 10.3389/fneur.2020.520633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/16/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Purpose: Early age exposure to the Chinese Great Leap Forward famine (1959–1961) is associated with the incidence of risk factors for ischemic stroke. This study aims to examine the relationship between early age famine exposure and 12-month stroke recurrence. We sought to explore the interaction between famine exposure status and metabolic phenotypes on stroke recurrence and how the adherence of crucial evidence-based key performance indicators (KPI) would modify this interaction. Methods: We analyzed data of patients who were born between 1953 and 1964 in the China National Stroke Registry II (CNSR-II). The study population was further divided into five subgroups for comparing 12-month stroke recurrence. A multivariate Cox proportional hazard regression model was used in analyzing the impact of the concurrence of metabolic phenotypes—type 2 diabetes (T2D) or metabolic syndrome (MetS)—and early-age famine exposure on recurrent risk. The influence of the adherence to predefined KPI and concurrency of metabolic phenotype was also evaluated. Results: Concurrent T2D and early age famine exposure was associated with an increased recurrence risk of ischemic stroke with 12 months [adjusted hazard ratio (HR): 1.63, 95% confidence interval (CI) 1.28–2.07]. Optimal adherence to KPI was not associated with significantly reduced risk of 12-month stroke recurrence (adjusted HR: 0.80, 95% CI: 0.51–1.26). Conclusions: Concurrency of early-age famine exposure and diabetes mellitus was associated with a higher risk of stroke recurrence within 12 months, and adherence to evidence-based KPI did not reduce the risk significantly.
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Affiliation(s)
- Yue Suo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Weiqi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Chunjuan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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7
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Gomez-Verjan JC, Barrera-Vázquez OS, García-Velázquez L, Samper-Ternent R, Arroyo P. Epigenetic variations due to nutritional status in early-life and its later impact on aging and disease. Clin Genet 2020; 98:313-321. [PMID: 32246454 DOI: 10.1111/cge.13748] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/11/2020] [Accepted: 03/27/2020] [Indexed: 12/21/2022]
Abstract
Epigenetics refers to changes in gene function, not resulting from the primary DNA sequence, influenced by the environment. It provides a link between the molecular regulation of the genome and the environmental signals exposed during the life of individuals (including lifestyle, social behavior, development, and nutrition). Notably, early development (intrauterine or postnatal) is highly influenced by the adverse socioeconomic status that leads to malnutrition or obesity; these conditions induce changes over the fetal epigenetic programming and can be transferred by transgenerational inheritance, inducing alterations of the transcription of genes related to several metabolic and neurological processes. Moreover, obesity during pregnancy, and excessive gestational weight gain are associated with an increased risk of fatal pregnancy complications, and adverse cardio-metabolic, respiratory and cognitive-related outcomes of the future child. However, most of our knowledge in this field comes from experimental animal models, that partially resemble the nutritional effects of humans. In this context, nutritional effects implicated in historical famines represent valuable information about the transgenerational effects of undernutrition and stress. In the present review, we attempt to describe the most outstanding results from the most studied famines about the impact of malnutrition on the epigenome.
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Affiliation(s)
- Juan C Gomez-Verjan
- División de Ciencias Básicas, Instituto Nacional de Geriatría (INGER), Mexico City, Mexico
| | | | - Lizbeth García-Velázquez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Rafael Samper-Ternent
- Geriatric/Sealy Center on Aging, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Pedro Arroyo
- División de Epidemiología, Instituto Nacional de Geriatría (INGER), Mexico City, Mexico
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8
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Rosales-Rueda M. The impact of early life shocks on human capital formation: evidence from El Niño floods in Ecuador. JOURNAL OF HEALTH ECONOMICS 2018; 62:13-44. [PMID: 30268992 DOI: 10.1016/j.jhealeco.2018.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 02/27/2018] [Accepted: 07/07/2018] [Indexed: 06/08/2023]
Abstract
This paper investigates the persistent effects of negative shocks in utero and in infancy on low-income children's health and cognitive outcomes and examines whether timing of exposure matters differentially by skill type. Specifically, I exploit the geographic intensity of extreme floods in Ecuador during the 1997-1998 El Niño phenomenon, which provides exogenous variation in exposure at different periods of early development. I show that children exposed to severe floods in utero, especially during the third trimester, are shorter in stature five and seven years later. Also, children affected by the floods in the first trimester of pregnancy score lower on cognitive tests. Additionally, I explore potential mechanisms by studying health at birth and family inputs (income, consumption, and breastfeeding). I find that children exposed to El Niño floods, especially during the third trimester in utero, were more likely to be born with low birth weight. Furthermore, households affected by El Niño suffered a decline in income, total consumption, and food consumption in the aftermath of the shock. Falsification exercises and robustness checks suggest that selection concerns such as selective fertility, mobility, and infant mortality do not drive these results.
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Affiliation(s)
- Maria Rosales-Rueda
- Rutgers University, Department of Economics, 360 Martin Luther King Jr. Blvd Newark, NJ 07102, United States.
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9
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Zanetti D, Tikkanen E, Gustafsson S, Priest JR, Burgess S, Ingelsson E. Birthweight, Type 2 Diabetes Mellitus, and Cardiovascular Disease: Addressing the Barker Hypothesis With Mendelian Randomization. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2018; 11:e002054. [PMID: 29875125 PMCID: PMC6447084 DOI: 10.1161/circgen.117.002054] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/01/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Low birthweight has been associated with a higher risk of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease. The Barker hypothesis posits that intrauterine growth restriction resulting in lower birthweight is causal for these diseases, but causality is difficult to infer from observational studies. METHODS We performed regression analyses to assess associations of birthweight with cardiovascular disease and T2D in 237 631 individuals from the UK Biobank. Further, we assessed the causal relationship of such associations using Mendelian randomization. RESULTS In the observational analyses, birthweight showed inverse associations with systolic and diastolic blood pressure (β, -0.83 and -0.26; per raw unit in outcomes and SD change in birthweight; 95% confidence interval [CI], -0.90 to -0.75 and -0.31 to -0.22, respectively), T2D (odds ratio, 0.83; 95% CI, 0.79-0.87), lipid-lowering treatment (odds ratio, 0.84; 95% CI, 0.81-0.86), and coronary artery disease (hazard ratio, 0.85; 95% CI, 0.78-0.94), whereas the associations with adult body mass index and body fat (β, 0.04 and 0.02; per SD change in outcomes and birthweight; 95% CI, 0.03-0.04 and 0.01-0.02, respectively) were positive. The Mendelian randomization analyses indicated inverse causal associations of birthweight with low-density lipoprotein cholesterol, 2-hour glucose, coronary artery disease, and T2D and positive causal association with body mass index but no associations with blood pressure. CONCLUSIONS Our study indicates that lower birthweight, used as a proxy for intrauterine growth retardation, is causally related with increased susceptibility to coronary artery disease and T2D. This causal relationship is not mediated by adult obesity or hypertension.
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Affiliation(s)
- Daniela Zanetti
- Division of Cardiovascular Medicine, Department of Medicine (D.Z., E.T., E.I.)
- Division of Cardiology, Department of Pediatrics (J.R.P.)
| | - Emmi Tikkanen
- Division of Cardiovascular Medicine, Department of Medicine (D.Z., E.T., E.I.)
| | - Stefan Gustafsson
- Stanford University School of Medicine, CA. Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (S.G., E.I.)
| | - James R Priest
- Division of Cardiology, Department of Pediatrics (J.R.P.)
| | - Stephen Burgess
- MRC Biostatistics Unit and Department of Public Health and Primary Care, University of Cambridge, United Kingdom (S.B.)
| | - Erik Ingelsson
- Division of Cardiovascular Medicine, Department of Medicine (D.Z., E.T., E.I.),
- and Stanford Cardiovascular Institute (D.Z., E.I.)
- Stanford University School of Medicine, CA. Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (S.G., E.I.)
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10
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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: 134] [Impact Index Per Article: 22.3] [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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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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Zhou J, Zhang L, Xuan P, Fan Y, Yang L, Hu C, Bo Q, Wang G, Sheng J, Wang S. The relationship between famine exposure during early life and body mass index in adulthood: A systematic review and meta-analysis. PLoS One 2018; 13:e0192212. [PMID: 29408921 PMCID: PMC5800668 DOI: 10.1371/journal.pone.0192212] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/19/2018] [Indexed: 01/01/2023] Open
Abstract
Background Previous epidemiologic studies have reported famine exposure during early life association with overweight or obesity in adulthood, but a consistent perspective has not been established to date. Purpose To determine, by conducting a systematic review and meta-analysis, whether exposure to famine could increase body mass index (BMI) in adult or not, and assess the association between famine exposure and the risk of overweight or obesity. Methods Published articles were systematically searched (until August, 2017) from PubMed, ScienceDirect, Cochrane, and China National Knowledge Infrastructure. Initially, comparing differences in BMI between exposed and non-exposed groups that weight mean difference (WMD) were used. Subsequently, the effect of famine exposure on overweight or obesity risk, which pooled relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Result Twenty studies were included in this systematic review and meta-analysis. Compared with non-exposed group, famine exposure group significantly increased the risk of overweight (OR = 1.10, 95% CI: 1.04–1.16) and obesity (OR = 1.15, 95% CI: 1.05–1.24). Sensitivity analyses revealed no significant change in the famine exposure and BMI, the risk of overweight and obesity study when any one study was excluded. Subgroup analyses showed that age, gender, exposure type, study type, continent, famine cause and paper publication date were associated with BMI, the risk of overweight and obesity. Meta-regression analyses suggested that continent, famine cause could partially explain heterogeneity for famine exposure and BMI studies. Conclusion The systematic review and meta-analysis indicates that famine exposure during early life may increase BMI, the risk of overweight and obesity, especially for female, fetal famine exposure or subject age less than 50. Furthermore, famine exposure group the risk of overweight and obesity in cross-sectional studies, Asian studies, famine cause by natural disaster or paper published from 2015 to the present studies are higher than that of non-exposed group.
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Affiliation(s)
- Jielin Zhou
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Liangjian Zhang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Peng Xuan
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Yong Fan
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Chunqiu Hu
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Qingli Bo
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Guoxiu Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
- * E-mail:
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Abstract
Anaemia is prevalent in developing countries and is commonly Fe deficiency related. We aimed to assess the association between Fe status, Fe intake and mortality among Chinese adults. We prospectively studied 8291 adults aged 20-98 years with a mean follow-up of 9·9 years. All participants were measured for Hb at baseline in 2002. Food intake, measured by 3-d weighed food record (n 2832), and fasting serum ferritin were measured. We documented 491 deaths (including 192 CVD and 165 cancer deaths) during 81 527 person-years of follow-up. There was a U-shaped association between Hb levels and all-cause mortality. Compared with the second quartile of Hb (121 g/l), the first (105) and fourth quartile (144) had hazard ratios (HR) of 2·29 (95 % CI 1·51, 3·48) and 2·31 (95 % CI 1·46, 3·64) for all-cause mortality in women. In men, compared with third quartile of Hb (143 g/l), first (122) and fourth quartiles (154) had 61 and 65 % increased risk of all-cause mortality. Anaemia was associated with an increased risk of all-cause and CVD mortality in men but not in women after adjusting for potential confounders. Low and high Fe intake as percentage of Chinese recommended nutrient intake (RNI) were positively associated with all-cause mortality in women but not in men. In women, across quartiles of relative Fe intake, HR for all-cause mortality were 2·55 (95 % CI 0·99, 6·57), 1·00, 3·12 (95 % CI 1·35, 7·18) and 2·78 (95 % CI 1·02, 7·58). Both low and high Hb levels are related to increased risk of all-cause mortality. Both low and high intake of Fe as percentage of RNI was positively associated with mortality in women.
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Chen JP, Peng B, Tang L, Sun R, Hu S, Wen XY, Que P, Wang YH. Fetal and infant exposure to the Chinese famine increases the risk of fatty liver disease in Chongqing, China. J Gastroenterol Hepatol 2016. [PMID: 26201820 DOI: 10.1111/jgh.13044] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Early life exposure to the famine may affect the susceptibility to the metabolic disorders. The objective of this study was to examine the associations of early life exposure to the Chinese Famine (1959-1961) with the risk of fatty liver disease, obesity, hypertension, and hyperglycemia in adulthood. METHODS We used the data of 10,935 adults born between 1956 and 1965 in Chongqing from check-up center at the 1st Affiliated Hospital of Chongqing Medical University in 2011. Logistic regression models were used to explore the effects of famine on the risk of fatty liver disease, obesity, hypertension, and hyperglycemia. RESULTS In Chongqing, prevalences of fatty liver disease among adults in non-exposed (1956-1958 plus 1963-1965) group and born in 1959, 1960, 1961, and 1962 were 34.01%, 36.42%, 34.63%, 40.27%, and 36.09%, respectively. Prevalences of fatty liver disease, obesity, hypertension, and hyperglycemia were significantly higher in males versus females. The risk of fatty liver disease was about 1.375-fold (1.303 (95% confidence interval, 1.066-1.594) for male, 1.547(95% confidence interval, 1.195-2.002) for female) higher in subjects born in 1961, and 1.142-fold (1.117 (95% confidence interval, 0.957-1.305) for male, 1.242 (95% confidence interval, 1.003-1.537) for female) higher in subjects born in 1962 after adjustment of age and sex, compared with non-exposed subjects. Early life exposure to the Chinese famine was also associated with the increased risk of obesity and hyperglycemia. CONCLUSIONS Exposure to the Chinese famine during fetal life and infancy was associated with an increased risk of fatty liver disease in adulthood.
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Affiliation(s)
- Jiang-Peng Chen
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Bin Peng
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Lan Tang
- The Public Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rong Sun
- The Public Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shan Hu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Yan Wen
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Ping Que
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yong-Hong Wang
- The Public Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Shi Z, Taylor AW. Nutritional determinants of anemia among adults in Eastern China. World J Transl Med 2015; 4:55-59. [DOI: 10.5528/wjtm.v4.i2.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/03/2015] [Accepted: 07/27/2015] [Indexed: 02/06/2023] Open
Abstract
Historically, Eastern China has the highest prevalence of anemia among adults in China. It is commonly believed that iron deficiency is the main cause of anemia in China. Iron fortified soysauce is used to prevent anemia. Findings from Jiangsu Nutrition Study suggest that diet is related to anemia in this region. However, iron deficiency is not the main cause. Micronutrients other than iron (e.g., riboflavin) need to be considered in the prevention of anemia in the region.
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Mijiti P, Yuexin Z, Min L, Wubuli M, Kejun P, Upur H. Prevalence and predictors of anaemia in patients with HIV infection at the initiation of combined antiretroviral therapy in Xinjiang, China. Int J STD AIDS 2014; 26:156-64. [PMID: 24810220 DOI: 10.1177/0956462414531935] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Summary We retrospectively analysed routinely collected baseline data of 2252 patients with HIV infection registered in the National Free Antiretroviral Treatment Program in Xinjiang province, China, from 2006 to 2011 to estimate the prevalence and predictors of anaemia at the initiation of combined antiretroviral therapy. Anaemia was diagnosed using the criteria set forth by the World Health Organisation, and univariate and multivariate logistic regression analyses were performed to determine its predictors. The prevalences of mild, moderate, and severe anaemia at the initiation of combined antiretroviral therapy were 19.2%, 17.1%, and 2.6%, respectively. Overall, 38.9% of the patients were anaemic at the initiation of combined antiretroviral therapy. The multivariate logistic regression analysis indicated that Uyghur ethnicity, female gender, lower CD4 count, lower body mass index value, self-reported tuberculosis infection, and oral candidiasis were associated with a higher prevalence of anaemia, whereas higher serum alanine aminotransferase level was associated with a lower prevalence of anaemia. The results suggest that the overall prevalence of anaemia at the initiation of combined antiretroviral therapy in patients with HIV infection is high in Xinjiang, China, but severe anaemia is uncommon. Patients in China should be routinely checked for anaemia prior to combined antiretroviral therapy initiation, and healthcare providers should carefully select the appropriate first-line combined antiretroviral therapy regimens for anaemic patients.
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Affiliation(s)
- Peierdun Mijiti
- Department of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, China
| | - Zhang Yuexin
- Department of Infectious Disease, Xinjiang Medical University First Affiliated Hospital, Urumqi, China
| | - Liu Min
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Maimaitili Wubuli
- Department of Infectious Disease, Xinjiang Medical University First Affiliated Hospital, Urumqi, China
| | - Pan Kejun
- Department of Infectious Disease, Xinjiang Medical University First Affiliated Hospital, Urumqi, China
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