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Shuai A, Ullah S, Yu Y, Pandol SJ, Barreto SG. Perinatal Famine Exposure and Young-Onset Cancer-Lessons from China Health and Nutrition Survey. Cancers (Basel) 2024; 16:2537. [PMID: 39061177 PMCID: PMC11275197 DOI: 10.3390/cancers16142537] [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: 06/21/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Perinatal exposure to malnutrition has been hypothesised to influence the development of young-onset cancer (≤50 years of age). This study aimed to determine if perinatal malnutrition in individuals exposed to the Great Famine of China increased their risk of developing young-onset cancer compared to other individuals born prior to the famine. Subjects/Methods: This cross-sectional study involved 7272 participants from the China Health and Nutrition Survey who were classified into four groups based on birth year: participants born between 1953 and 1955 (before the famine) were designated as the pre-famine group (unexposed); the remainder formed perinatal exposure groups comprised of those exposed during the famine (1959-1961), those exposed in the early post-famine period (1962-1964), and those exposed in the late post-famine period (1965-1967). Multivariable adjusted log-binomial regression models were used to calculate the RR and 95% CI of young-onset cancer (including genitourinary cancer) across four groups. Results: Perinatal exposure to early post-famine (RR 2.08; 95%CI 1.04, 4.34; p = 0.043) and the female sex (RR 15.6, 95%CI 4.54, 60.3; p < 0.001) were noted to have a significantly increased risk of young-onset cancer. In addition, the early (RR 13.8; 95%CI 2.68, 253; p = 0.012) and late post-famine (RR 12.3; 95%CI 2.16, 231; p = 0.020) cohorts demonstrated a significantly increased risk of young-onset genitourinary cancer. The latter was accompanied by an increased risk of hypertension (RR 3.30; 95%CI 1.28, 7.87; p = 0.009). Conclusions: Perinatal exposure to famine, especially in females, was associated with a higher risk of young-onset cancer. This was particularly evident for young-onset genitourinary cancers. These findings highlight the potential long-term impact of perinatal malnutrition on young-onset carcinogenesis.
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Affiliation(s)
- Aidi Shuai
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia;
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia;
| | - Yongfu Yu
- School of Public Health, Shanghai Medical College, Fudan University, Shanghai 200031, China;
| | - Stephen J. Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - Savio George Barreto
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia;
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia
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Wang C, Wang J, Wan R, Yuan T, Yang L, Zhang D, Li X, Liu H, Zhang L. Separate and combined effects of famine exposure and menarche age on metabolic syndrome among the elderly: a cross-sectional study in China. BMC Womens Health 2023; 23:600. [PMID: 37964223 PMCID: PMC10648701 DOI: 10.1186/s12905-023-02737-x] [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: 01/10/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Epidemiological studies have revealed multiple risk factors for metabolic syndrome. However, there are no consistent findings on the association between famine exposure, age at menarche, and the prevalence of metabolic syndrome. This cross-sectional study aimed to reveal the individual and combined effects of famine exposure and age at menarche on the prevalence of metabolic syndrome among elderly women. METHODS Four thousand seven hundred seventy participants between 60 and 93 years of age were selected from the China Health and Retirement Longitudinal Study. Statistical differences between the baseline characteristics of famine exposure, age at menarche, and metabolic syndrome were evaluated using the t-test, F-test, and Chi-square test. Three multivariable-adjusted logistic regression models were used to test the association between famine exposure, age of menarche, and the odds ratio of metabolic syndrome. RESULTS Two thousand one hundred ninety-eight (46.08%) participants had metabolic syndrome, while 2572 (53.92%) participants did not. Furthermore, 3068 (64.32%) women reported onset of menarche under 15 years of age, while 1702 (35.68%) women reported onset of menarche above 16 years of age. Regarding the separate association of famine exposure and age of menarche with metabolic syndrome, in model three, the adolescence/adulthood famine exposure group vs. no famine exposure group odds ratio was 2.45 (95% CI 2.02, 2.97), and the older than 16 years vs. younger than 15 years group odds ratio was 1.23 (95% CI 1.09, 1.39), which was the highest odds ratio among the three models. Regarding the combined association of famine exposure and age of menarche with metabolic syndrome, in model three, among the age of menarche ≤ 15 years group, the adolescence/adulthood famine exposure vs. no famine exposure group odds ratio was 2.45 (95% CI: 1.91, 3.14); among the menarche age ≥ 16 years group, the adolescence/adulthood famine exposure stages vs. exposed group odds ratio was 3.27 (95% CI: 2.44, 4.38), which was the highest odds ratio among the three models. CONCLUSION These findings suggested that famine exposure and age at menarche, either separately or in combination, were positively associated with the prevalence of metabolic syndrome among older women.
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Affiliation(s)
- Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, An Hui Province, Wuhu City, 241000, P.R, China
| | - Jiazhi Wang
- Sports Institute, Chi Zhou College, Education Park, Chi Zhou City, An Hui Province, People's Republic of China
| | - Rui Wan
- Business School, Yunnan University of Finance and Economics, 237 Longquan Road, Kunming City, Yun Nan Province, People's Republic of China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, An Hui Province, Wuhu City, 241000, P.R, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, 22 Wenchang West Road, Higher Education ParkAn Hui Province, Wuhu City, People's Republic of China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, An Hui Province, Wuhu City, 241000, P.R, China.
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Wu T, Yan X, Liu Y, Ma N, Dang J, Zhong P, Shi D, Cai S, Cheng H, Song Y, Lau PWC. Association between early life exposure to the great famine and possible sarcopenia in older Chinese adults: a national cross-sectional study. BMJ Open 2023; 13:e065240. [PMID: 36858468 PMCID: PMC9980362 DOI: 10.1136/bmjopen-2022-065240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES We used data from the China Health and Retirement Longitudinal Study (CHARLS) to investigate how an early life famine exposure affected possible sarcopenia (PS) and to explore the extent to which a sex difference exists in the association among older Chinese adults, as well as whether risk factors modify the association. DESIGN Cross-sectional study. SETTING 28 provinces of China. PARTICIPANTS Considering that the Great Chinese Famine lasted from the spring of 1959 to the fall of 1961, 3557 participants were selected and categorised into four subgroups based on their date of birth: unexposed group (1 October 1962 to 30 September 1964), fetal exposed group (1 October 1959 to 30 September 1961), infant exposed group (1 January 1958 to 31 December 1958) and preschool exposed group (1 January 1956 to 31 December 1957). OUTCOME MEASURE PS was defined as having low muscle strength or low physical performance. METHODS We used multivariable logistic models to analyse the association between early life famine exposure and the risk of PS in elderly life. RESULTS The prevalences of PS among individuals in the unexposed, fetal, infant and preschool exposed groups were 15.1%, 14.4%, 23.6% and 21.9%, respectively. Compared with the unexposed group, the infant (OR: 1.55; 95% CI 1.17 to 2.05) and preschool exposed (OR: 1.46; 95% CI 1.17 to 1.82) groups exhibited significantly higher risks of PS. In men, the infant (OR: 2.15; 95% CI 1.40 to 3.31) and preschool exposed (OR: 1.78; 95% CI 1.23 to 2.57) groups were more likely to have PS, but no significant increase was seen in women. In both sexes, prevalence of PS was unrelated to early life famine exposure in the urban, underweight and normal weight subgroups. CONCLUSIONS Early life exposure to the Great Chinese Famine was associated with a higher risk of PS in older adults. Keeping normal nutritional status in elderly life might help avoid the risk of PS, whatever the effect of early famine exposure.
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Affiliation(s)
- Ting Wu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Xiaojin Yan
- Institute of Population Research, Peking University, Beijing, China
| | - Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Ning Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jiajia Dang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Di Shi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Shan Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Hao Cheng
- National Academy of Innovation Strategy, China Association for Science and Technology, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Patrick W C Lau
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Laboratory of Exercise Science and Health, BNU-HKBU United International College, Zhuhai, China
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Yang J, Xu H, Li J, Zhao Y, Guan S, Fu Y, Bao R, Liu Z. The association between undiagnosed diabetes and cognitive function: findings from the China health and retirement longitudinal study. BMC Endocr Disord 2022; 22:151. [PMID: 35658946 PMCID: PMC9167534 DOI: 10.1186/s12902-022-01055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The cognitive function of people with diabetes has gained an increasing interest in recent years, and this study focuses on exploring the relationship between undiagnosed diabetes and cognitive function among the middle-aged and elderly people in China. METHODS The data came from the China Health and Retirement Longitudinal Study (CHARLS) which was conducted between July and October 2015. 9855 subjects were enrolled in the study. Executive function and episodic memory were used to assess cognitive function. The subjects were divided into three groups: no diabetes, diagnosed diabetes, and undiagnosed diabetes, and weighted multiple linear regression models were established to evaluate the association of undiagnosed diabetes with cognitive function. RESULTS After controlling for covariates, undiagnosed diabetes was statistically associated with executive function (β = -0.215, P < 0.01). In the age group of ≥65 years, undiagnosed diabetes was statistically associated with executive function (β = -0.358, P < 0.01) and episodic memory (β = -0.356, P < 0.01). When adjusting for confounders, no statistically significant associations were found between diagnosed diabetes and cognitive function except in 45-54 age group (β = 0.374, P < 0.05). CONCLUSIONS The cross-sectional study suggested that undiagnosed diabetes was linked to poor cognitive function, especially in the elderly population. Timely diagnosis and active treatment of diabetes are important to reduce the occurrence of cognitive impairment. Further prospective cohort studies are required to articulate the association between undiagnosed diabetes and cognitive function.
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Affiliation(s)
- Jiafei Yang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Haiming Xu
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Yu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Suzhen Guan
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Youjuan Fu
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Rui Bao
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Zhihong Liu
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China.
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China.
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Sun N, Li W, Osibogun O, Kalan ME, Jebai R, Gautam P, Taskin T, Yin W, Jones JA, Gamber M, Sun W. Adolescence exposure to China's great famine period and the association of metabolic syndrome in adulthood: a retrospective study. BMC Public Health 2022; 22:688. [PMID: 35395755 PMCID: PMC8991788 DOI: 10.1186/s12889-022-13047-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exposure to famine during early life is related to several adverse health outcomes in adulthood, but the effect of famine exposure during adolescence is unclear. This study aims to examine whether exposure to famine in adolescence is associated with metabolic syndrome (MetS) in adulthood. METHODS This study included 4130 Chinese adults (2059 males and 2071 females) aged 59-71 from the 2011 China Health and Retirement Longitudinal Study (CHARLS). All the selected participants were exposed to the three-year time period (1959-1961) of China's Great Famine. Participants were categorized into an adolescent-exposed group (born 01/01/1944-12/31/1948) and a non-adolescent-exposed group (born 01/01/1940-12/31/1941 and 01/01/1951-12/31/1952). Sex-stratified multiple logistic regression models were used to estimate the association between exposure to famine in adolescence and MetS. RESULTS Participants exposed to famine during adolescence were more likely to report MetS (aOR = 1.35; 95%CI 1.01-1.78) compared to the non-adolescent-exposed group. Further, males were 45% less likely to report MetS than females (aOR = 0.55; 95%CI 0.36-0.83). After stratification by sex, the effects of famine exposure during adolescence on MetS were detected among males only (aOR = 1.97; 95%CI 1.20-3.24). Additionally, males with a history of drinking were more likely to report MetS compared to those with no history of drinking (aOR = 2.63; 95%CI 1.41-4.90). CONCLUSIONS Our findings reveal that exposure to famine during adolescence is associated with higher odds of MetS in adulthood overall, and this association is only pronounced among males. This study emphasizes that undernutrition in early life, including adolescence, may have a long-term effect and be associated with adverse health events in middle-to-late life. Targeting those elderly people who suffered famine during adolescence may help prevent the development of MetS in later life.
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Affiliation(s)
- Ning Sun
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Mohammad Ebrahimi Kalan
- School of Medicine, Linberger Comprehensive Cancer Center, University of North Carolina in Chapel Hill, Chapel Hill, NC, USA
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Tanjila Taskin
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Wupeng Yin
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Jeffery A Jones
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Michelle Gamber
- School of Health Professions, Shenandoah University, 1775 North Sector Court, Suite 220 B, Winchester, VA, 22601, USA.
| | - Wenjie Sun
- Center for Health Sciences, Oklahoma State University, 1111 W. 17th Street, Tulsa, OK, 74017, USA.
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Sun M, Bo Q, Lu B, Sun X, Zhou M. The Association of Sleep Duration With Vision Impairment in Middle-Aged and Elderly Adults: Evidence From the China Health and Retirement Longitudinal Study. Front Med (Lausanne) 2022; 8:778117. [PMID: 35004745 PMCID: PMC8738086 DOI: 10.3389/fmed.2021.778117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
Objective: This study aims to investigate the association of sleep duration with vision impairment (VI) in middle-aged and elderly adults. Methods: This cross-sectional study used the data from the baseline survey of the China Health and Retirement Longitudinal Study (CHARLS) 2011–2012, a national survey of adults aged 45 years or older. Weighted multilevel logistic regression models were used to evaluate the association between self-reported sleep duration and VI. Results: Of the 13,959 survey respondents, a total of 4,776 (34.2%) reported VI. The prevalence of short (≤6 h/night) and long (>8 h/night) sleep durations was higher among respondents with VI than those without VI (P < 0.001). Multilevel logistic regression models showed that compared with a sleep duration of 6–8 h/night, a sleep duration of ≤6 h/night was associated with a 1.45-fold [95% confidence interval (CI) = 1.34–1.56] higher VI risk, and a sleep duration of >8 h/night was associated with a 1.18-fold (95% CI = 1.03–1.34) higher VI risk, after adjusting for sociodemographic data, lifestyle factors, and health conditions. Vision impairment was associated with short sleep duration in respondents from all age or gender categories. However, VI was associated with long sleep duration in respondents from the elderly or female categories. The association between VI and long sleep duration disappeared in respondents of middle-aged or male categories. Conclusions: The potential impact of sleep on the risk of visual functions requires further attention. A more comprehensive and integrated health care and rehabilitation system covering vision and sleep is also needed.
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Affiliation(s)
- Mengsha Sun
- Department of Ophthalmology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qiyu Bo
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Lu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
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7
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Xu Y, Yi Q, Shan S, Zhou J, Li S, Hou L, Ye X, Ying J, Song P, An L. Chinese famine exposure in early life and metabolic obesity phenotype in middle age: Results from the China health and retirement longitudinal study. Front Endocrinol (Lausanne) 2022; 13:975824. [PMID: 36204102 PMCID: PMC9531307 DOI: 10.3389/fendo.2022.975824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the association between early life exposure to famine and the risk of metabolic obesity phenotypes among adults in middle age. METHODS The study selected two comparison groups. Comparison A consisted of a non-exposed group born between 1963-1965 from the China Health and Retirement Longitudinal Study (CHARLS) 2015 wave (N=862) and a fetal-exposed group born between 1959-1961 from the 2011 wave (N=507). Comparison B consisted of an early childhood-exposed group born between 1955-1957 from the 2011 wave (N=830) and a fetal-exposed group born between 1959-1961 from the 2015 wave (N=552). Multivariable logistic regressions were conducted to explore the associations between different periods of famine exposure and obesity, metabolic health status, and metabolic obesity phenotypes, with stratification by sex. RESULTS Compared with the non-exposed group, participants exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.78, 95%CI: 0.63-0.97) and a higher risk of metabolically unhealthy status (OR: 1.73, 95%CI: 1.34-2.23) and metabolically unhealthy non-obesity (MUNO) (OR: 2.12, 95%CI: 1.46-3.08) at the age of 50-52 years. In the sex-stratified analysis, males exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.59, 95%CI: 0.43-0.80) and metabolically healthy obesity (MHO) (OR: 0.56, 95%CI: 0.37-0.85), while such associations were not found in females. Compared with the early childhood exposure group, participants in the fetal exposure group had a significantly lower risk of metabolic unhealthy status (OR: 0.65, 95%CI: 0.51-0.85) and MUNO (OR: 0.50, 95%CI: 0.35-0.72). Those associations were observed in both males and females. CONCLUSION Exposure to famine in early life increased the risk of metabolically unhealthy status in adulthood. Different metabolic subtypes should be identified at an early stage and followed by classification, intervention, and treatment.
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Affiliation(s)
- Yunhan Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Qian Yi
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Shiyi Shan
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiali Zhou
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuting Li
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Leying Hou
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinxin Ye
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- Department of Sport and Exercise Science, College of Education, Zhejiang University, Hangzhou, China
| | - Jiayao Ying
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Peige Song
- School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Lin An, ; Peige Song,
| | - Lin An
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- *Correspondence: Lin An, ; Peige Song,
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8
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Wang M, Liu M, Guo C, Li F, Liu Z, Pan Y, Liu F, Liu Y, Bao H, Hu Z, Cai H, He Z, Ke Y. Association of early-life undernutrition and risk of dyslipidemia in adulthood: a population-based cohort study. BMC Public Health 2021; 21:2129. [PMID: 34801023 PMCID: PMC8605529 DOI: 10.1186/s12889-021-12211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association of early-life undernutrition and dyslipidemia found in previous studies may be confounded by the uncontrolled age difference between exposed and unexposed participants. The study aimed to investigate the association of early-life undernutrition and the risk of dyslipidemia in adulthood with good control of the age variable. METHODS We took the Great Chinese Famine (1959-1961) as a natural experiment of severe undernutrition. This study was based on the baseline investigation of a population-based cohort in rural China. Undernutrition in early life was defined as being exposed to famine at younger than 3 years of age. Three approaches including Adjustment, Restriction, and Matching were applied to control the confounding effect of age. Logistic regression models were applied to evaluate the association between early-life famine and the presence of dyslipidemia. Stratified analysis by gender was also performed, and potential effect modification was tested by adding the interaction term of the famine exposure variable and gender into the model. RESULTS Undernutrition in early life was associated with increased risk of borderline high and above (BHA) levels of total cholesterol (TC, ORAdjustment = 1.61; ORRestriction = 1.56; ORMatching = 1.87), triglycerides (TG, ORAdjustment = 1.33; ORRestriction = 1.30; ORMatching = 1.34), low-density lipoprotein cholesterol (LDL-C, ORAdjustment = 1.75; ORRestriction = 1.53; ORMatching = 1.77) and dyslipidemia (ORAdjustment = 1.52; ORRestriction = 1.45; ORMatching = 1.60), as well as high levels of TC, TG, LDL-C and dyslipidemia. An inverse association of undernutrition and risk of low high-density lipoprotein cholesterol (HDL-C) was found. Female participants with undernutrition experience had an increased risk of BHA TG and LDL-C (TG: ORAdjustment, female = 1.45; ORRestriction, female = 1.39; ORMatching, female = 1.51; LDL-C: ORAdjustment, female = 2.11; ORRestriction, female = 1.80; ORMatching, female = 2.15), but this association was not found in males. CONCLUSION Early-life undernutrition increased the risk of TC, TG, LDL-C, and dyslipidemia. Gender would significantly modify this effect for TG and LDL-C. These results emphasize the importance of nutritional conditions in the early stages of life to long-term health consequences.
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Affiliation(s)
- Minmin Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Mengfei Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Chuanhai Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Fenglei Li
- Hua County People's Hospital, Anyang, Henan Province, China
| | - Zhen Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Yaqi Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Fangfang Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Ying Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Huanyu Bao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Zhe Hu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Hong Cai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China
| | - Zhonghu He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China.
| | - Yang Ke
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China.
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Li W, Sun N, Kondracki AJ, Kiplagat S, Osibogun O, Kalan ME, Jebai R, Sun W, Wei Z. Exposure to famine in early life and self-rated health status among Chinese adults: a cross-sectional study from the Chinese Health and Retirement Longitudinal Study (CHARLS). BMJ Open 2021; 11:e048214. [PMID: 34642191 PMCID: PMC8513269 DOI: 10.1136/bmjopen-2020-048214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE China's Great Famine between 1959 and 1961 has contributed to numerous adverse health outcomes in Chinese. This study aimed to examine the association between exposure to famine in early life and self-rated health (SRH) in adulthood. METHODS 4418 Chinese adults from the 2011 China Health and Retirement Longitudinal Study were included in the analysis. Multivariable logistic regression was conducted to estimate adjusted ORs (aORs) and 95% CIs of the association between exposure to famine in early life and SRH, stratified by sex. RESULTS Participants exposed to famine during infancy were more likely to report poor SRH (aOR 1.33; 95% CI 1.04 to 1.70) compared with the non-exposed group, adjusting for confounders. Males were 32% less likely than females to report poor SRH (aOR 0.68; 95% CI 0.54 to 0.86). Participants diagnosed with chronic diseases (aOR 3.11; 95% CI 2.68 to 3.61), disability (aOR 1.82; 95% CI 1.38 to 2.38) and vision impairment (aOR 2.07; 95% CI 1.72 to 2.49) were more likely to report poor SRH. Participants who were current alcohol users and with abnormal weight were less likely to report poor SRH. Stratification by sex showed no significant association between famine and SRH among males, but a consistently significant association was observed among females (aOR 1.46; 95% CI 1.02 to 2.12). CONCLUSIONS Findings from this study indicated that females exposed to famine in China during infancy were more likely to report poor SRH in their adulthood. Implementing interventions to those who were exposed to famine in early life, especially for females, may improve their long-term consequences.
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Affiliation(s)
- Wei Li
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Ning Sun
- Department of Biostatistics, Florida International University, Miami, Florida, USA
| | - Anthony J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia, USA
| | - Sandra Kiplagat
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Mohammad Ebrahimi Kalan
- Department of Health Behavior, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Rime Jebai
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Wenjie Sun
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Zhen Wei
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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10
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Early-life nutrition and metabolic disorders in later life: a new perspective on energy metabolism. Chin Med J (Engl) 2021; 133:1961-1970. [PMID: 32826460 PMCID: PMC7462214 DOI: 10.1097/cm9.0000000000000976] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes mellitus and metabolic disorders have become an epidemic globally. However, the pathogenesis remains largely unclear and the prevention and treatment are still limited. In addition to environmental factors during adulthood, early life is the critical developmental window with high tissue plasticity, which might be modified by external environmental cues. Substantial evidence has demonstrated the vital role of early-life nutrition in programming the metabolic disorders in later life. In this review, we aim to overview the concepts of fetal programming and investigate the effects of early-life nutrition on energy metabolism in later life and the potential epigenetic mechanism. The related studies published on PubMed database up to March 2020 were included. The results showed that both maternal overnutrition and undernutrition increased the riskes of metabolic disorders in offspring and epigenetic modifications, including DNA methylation, miRNAs, and histone modification, might be the vital mediators. The beneficial effects of early-life lifestyle modifications as well as dietary and nutritional interventions on these deleterious metabolic remolding were initially observed. Overall, characterizing the early-life malnutrition that reshapes metabolic disease trajectories may yield novel targets for early prevention and intervention and provide a new point of view to the energy metabolism.
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11
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Zhang Q, Liu C, Wang Y, Gong J, Wang G, Ge W, Chen R, Meng X, Zhao Y, Kan H. Associations of long-term exposure to ambient nitrogen dioxide with indicators of diabetes and dyslipidemia in China: A nationwide analysis. CHEMOSPHERE 2021; 269:128724. [PMID: 33162153 PMCID: PMC7904633 DOI: 10.1016/j.chemosphere.2020.128724] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND The associations between ambient NO2 and diabetes and dyslipidemia have been controversial, and data is especially lacking in developing countries. OBJECTIVE This study aimed to assess the associations of long-term exposure to NO2 with diabetes and dyslipidemia in China. METHODS We conducted a cross-sectional study including 13,013 participants from the China Health and Retirement Longitudinal Study (CHRLS). The annual average concentrations of NO2 were estimated based on the residential addresses of participants. We applied logistic regression models to evaluate the associations of NO2 with diabetes and dyslipidemia, and linear regression models to assess the associations with blood biomarkers. RESULTS A total of 1933 diabetes cases (14.85%) and 1935 (14.87%) dyslipidemia cases were identified. Significant associations were observed between NO2 and risk of diabetes and dyslipidemia independent of PM2.5 and O3. For an interquartile range (IQR) increase in NO2 (12.39 μg/m3), we observed a 13% [odds ratio (OR): 1.13; 95% confidence interval (CI): 1.01, 1.26] increased risk of diabetes, 1.48% (95%CI: 0.51%, 2.46%) increase in glucose, 0.74% (95%CI: 0.19%, 1.29%) increase in glycosylated hemoglobin (HbA1c), 17% (OR: 1.17; 95% CI: 1.05, 1.31) increased risk of dyslipidemia, 4.62% (95%CI: 2.49%, 6.79%) increase in triglyceride, and a decrease of 2.96% (95%CI: 2.13%, 3.79%) in high-density lipoprotein. The associations of NO2 with glucose disorders were stronger among smokers. CONCLUSIONS Our study indicated long-term exposure to NO2 might contribute to the development of diabetes and dyslipidemia, and the associations were potentially independent of O3 and PM2.5.
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Affiliation(s)
- Qingli Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yafeng Wang
- Institute of Social Surveys, Peking University, Beijing, China
| | - Jinquan Gong
- Institute of Social Surveys, Peking University, Beijing, China
| | - Gewei Wang
- Institute of Social Surveys, Peking University, Beijing, China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., New York, 10591, USA
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
| | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
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12
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Grey K, Gonzales GB, Abera M, Lelijveld N, Thompson D, Berhane M, Abdissa A, Girma T, Kerac M. Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review. BMJ Glob Health 2021; 6:e003161. [PMID: 33692144 PMCID: PMC7949429 DOI: 10.1136/bmjgh-2020-003161] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Child malnutrition (undernutrition) and adult non-communicable diseases (NCDs) are major global public health problems. While convincing evidence links prenatal malnutrition with increased risk of NCDs, less is known about the long-term sequelae of malnutrition in childhood. We therefore examined evidence of associations between postnatal malnutrition, encompassing documented severe childhood malnutrition in low/middle-income countries (LMICs) or famine exposure, and later-life cardiometabolic NCDs. METHODS Our peer-reviewed search strategy focused on 'severe childhood malnutrition', 'LMICs', 'famine', and 'cardiometabolic NCDs' to identify studies in Medline, Embase, Global Health, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. We synthesised results narratively and assessed study quality with the UK National Institute for Health and Care Excellence checklist. RESULTS We identified 57 studies of cardiometabolic NCD outcomes in survivors of documented severe childhood malnutrition in LMICs (n=14) and historical famines (n=43). Exposure to severe malnutrition or famine in childhood was consistently associated with increased risk of cardiovascular disease (7/8 studies), hypertension (8/11), impaired glucose metabolism (15/24) and metabolic syndrome (6/6) in later life. Evidence for effects on lipid metabolism (6/11 null, 5/11 mixed findings), obesity (3/13 null, 5/13 increased risk, 5/13 decreased risk) and other outcomes was less consistent. Sex-specific differences were observed in some cohorts, with women consistently at higher risk of glucose metabolism disorders and metabolic syndrome. CONCLUSION Severe malnutrition or famine during childhood is associated with increased risk of cardiometabolic NCDs, suggesting that developmental plasticity extends beyond prenatal life. Severe malnutrition in childhood thus has serious implications not only for acute morbidity and mortality but also for survivors' long-term health. Heterogeneity across studies, confounding by prenatal malnutrition, and age effects in famine studies preclude firm conclusions on causality. Research to improve understanding of mechanisms linking postnatal malnutrition and NCDs is needed to inform policy and programming to improve the lifelong health of severe malnutrition survivors.
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Affiliation(s)
- Kelsey Grey
- Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Gerard Bryan Gonzales
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Mubarek Abera
- Department of Psychiatry, Jimma University, Jimma, Ethiopia
| | | | - Debbie Thompson
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Melkamu Berhane
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
| | | | - Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
| | - Marko Kerac
- Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Tao B, Yang P, Wang C, Du W, Shen P, Wu Y, Ding X, Chen S, Wu S, Li Y. Fetal exposure to the Great Chinese Famine and risk of ischemic stroke in midlife. Eur J Neurol 2020; 28:1244-1252. [PMID: 33263194 DOI: 10.1111/ene.14661] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Epidemiological studies have reported an association between famine exposure and increased risk of cardiovascular disease. However, it is unclear whether fetal exposure to the Great Chinese Famine of 1959 to 1961 was associated with risk of ischemic stroke in midlife. METHODS A total of 17,787 participants of the Kailuan study, who were free of cardiovascular disease and cancer at baseline (2006) were enrolled in the study. All participants were divided into three groups: unexposed (born between 1 October 1962 and 30 September 1964, used as the reference group in current analyses), fetal exposure (born between 1 October 1959 and 30 September 1961), and early childhood exposure (born between 1 October 1956 and 30 September 1958). Incident ischemic stroke cases between 2006 and 2017 were confirmed by review of medical records. Cox proportional hazards regression was applied to analyze the effect of fetal famine exposure on ischemic stroke risk. RESULTS During the mean (10.4 ± 2.2) years of follow-up, 547 incident ischemic stroke cases were identified. After adjustment for potential confounders, the hazard ratio (HR) for ischemic stroke was 1.45, and the 95% confidence interval (CI) was 1.14, 1.84 for fetal famine-exposed compared with unexposed individuals. Similar associations were observed in men (adjusted HR: 1.40; 95% CI: 1.08, 1.80) and overweight individuals (adjusted HR: 1.56; 95% CI: 1.18, 2.07), but not in their counterparts. The results of the early childhood-exposed group were similar to the above. CONCLUSIONS Our findings support an association between fetal malnutrition and higher risk of ischemic stroke in adulthood.
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Affiliation(s)
- Boni Tao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Peng Yang
- Department of Neurosurgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Cun Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Wei Du
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Peixuan Shen
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Ying Wu
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xiong Ding
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yun Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
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Xiao Y, Liu D, Cline MA, Gilbert ER. Chronic stress and adipose tissue in the anorexic state: endocrine and epigenetic mechanisms. Adipocyte 2020; 9:472-483. [PMID: 32772766 PMCID: PMC7480818 DOI: 10.1080/21623945.2020.1803643] [Citation(s) in RCA: 2] [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] [Indexed: 12/15/2022] Open
Abstract
Although adipose tissue metabolism in obesity has been widely studied, there is limited research on the anorexic state, where the endocrine system is disrupted by reduced adipose tissue mass and there are depot-specific changes in adipocyte type and function. Stress exposure at different stages of life can alter the balance between energy intake and expenditure and thereby contribute to the pathogenesis of anorexia nervosa. This review integrates information from human clinical trials to describe endocrine, genetic and epigenetic aspects of adipose tissue physiology in the anorexic condition. Changes in the hypothalamus-pituitary-thyroid, -adrenal, and -gonadal axes and their relationships to appetite regulation and adipocyte function are discussed. Because of the role of stress in triggering or magnifying anorexia, and the dynamic but also persistent nature of environmentally-induced epigenetic modifications, epigenetics is likely the link between stress and long-term changes in the endocrine system that disrupt homoeostatic food intake and adipose tissue metabolism. Herein, we focus on the adipocyte and changes in its function, including alterations reinforced by endocrine disturbance and dysfunctional adipokine regulation. This information is critical because of the poor understanding of anorexic pathophysiology, due to the lack of suitable research models, and the complexity of genetic and environmental interactions.
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Affiliation(s)
- Yang Xiao
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Dongmin Liu
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Mark A. Cline
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Elizabeth R. Gilbert
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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15
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Ding XY, Yang ZY, Zhao LY, Zhao WH. Are Lipid Profiles in Middle Age Associated with Famine Exposure during Prenatal and Early Postnatal Period? Nutrients 2020; 12:nu12082266. [PMID: 32751112 PMCID: PMC7469046 DOI: 10.3390/nu12082266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Undernutrition during early life may increase the risk of chronic diseases in adulthood, including dyslipidemia. Few investigations have confirmed the relationship between early life undernutrition and dyslipidemia in adulthood in China. Objectives: To assess the relationship between the Great Chinese Famine exposure during prenatal period or early postnatal period and lipid profiles in adulthood. Design: Data were extracted from the China Nutrition and Health Survey (CNHS) in 2010–2012, which included the participants who experienced the Great Chinese Famine during early life. Results: Participants who experienced the Great Chinese Famine in early postnatal period had a significantly higher prevalence of elevated total cholesterol (TC) (odds ratio: 1.60; 95% CI: 1.27, 2.02) than unexposed participants. Female (odds ratio: 1.71; 95% CI: 1.27, 2.31) were high risk than male (odds ratio: 1.46; 95% CI: 1.01, 2.11) and physical inactivity group (odds ratio: 1.65; 95% CI: 1.18, 2.29) were high risk than adequate physical activity group (odds ratio: 1.58; 95% CI: 1.21, 2.07). Similar effect of famine exposure on elevated low-density lipoprotein cholesterol (LDL-C) was observed, except that no significant difference was found between adequate physical activity group and physical inactivity group. Participants who experienced the Great Chinese Famine in prenatal period had a significantly higher prevalence of lowed high-density lipoprotein cholesterol (HDL-C) (odds ratio: 1.19; 95% CI: 1.03, 1.37) than unexposed. Female were more likely to have lower HDL-C (odds ratio: 1.44; 95% CI: 1.18, 1.74), but not found in male. Participants with physical inactivity were more likely to have lower HDL-C (odds ratio: 1.28; 95% CI: 1.02, 1.61), but not found in adequate physical activity group. Conclusions: People who experienced the Great Chinese Famine during early life, especially in females and people physical inactivity, would impair of lipid profiles in later life. Healthy lifestyle like adequate physical activity may partially alleviate the adverse effects.
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Wang Z, Song J, Li C, Li Y, Shen L, Dong B, Zou Z, Ma J. DNA methylation of the INSR gene as a mediator of the association between prenatal exposure to famine and adulthood waist circumference. Sci Rep 2020; 10:12212. [PMID: 32699300 DOI: 10.1038/s41598-020-69120-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 07/07/2020] [Indexed: 12/14/2022] Open
Abstract
The aims of this study were to explore whether DNA methylation at INSR and IGF2 mediated the association of prenatal exposure to the Chinese great famine with adulthood waist circumference (WC) and BMI. A total of 235 subjects were selected into the present study from severely affected province and a neighbor province with less severely affected famine in China through multi-stage clustered random sampling. DNA methylation at the INSR and IGF2 gene promoter regions was detected by the Sequenom's MassARRAY system. The "mediation" package of R was used to evaluate the mediation effect of DNA methylation on the association between prenatal exposure to the famine and adult WC and BMI. The results showed that prenatal famine exposure was significantly associated with higher overall methylation level of the INSR gene (d = 3.6%; 95% CI 1.2-6.0; P = 0.027) and larger adulthood WC (d = 2.72 cm; 95% CI 0.20-5.24; P = 0.034). Furthermore, famine significantly increased methylation levels at four CpG sites. Methylation of the CpG7 site mediated 32.0% (95% CI 5.0-100.0%, P = 0.029) of the association between prenatal exposure to the Chinese great famine and adulthood WC. In conclusion, Epigenetic changes to the INSR might mediate the adverse effect of prenatal famine exposure on WC in adulthood.
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Affiliation(s)
- Zhenghe Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jieyun Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Changwei Li
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, USA
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Luqi Shen
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, USA
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China. .,National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, 100191, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
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17
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Effects of prenatal exposure to the 1983-1985 Ethiopian great famine on the metabolic syndrome in adults: a historical cohort study. Br J Nutr 2020; 124:1052-1060. [PMID: 32517836 DOI: 10.1017/s0007114520002123] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Ethiopian great famine was one of the severe forms of global famines ever documented in Africa as well as in the recent history of the world. Earlier famine studies, as natural experiments, had tested the association between prenatal famine exposure and the metabolic syndrome and reported heterogeneous findings. Hence, this study aimed at evaluating the effects of prenatal exposure to the 1983-1985 Ethiopian great famine on the metabolic syndrome in adults. Self-reported birth date and age of the study subjects were used to classify the status of famine exposure. The International Diabetes Federation criterion was used to assess the metabolic syndrome. Multivariable logistic regression models were fitted to examine relationship between prenatal famine exposure and the metabolic syndrome. The findings showed that, adjusted for covariates, adults who had prenatal exposure to famine were 2·94 times more likely to develop the metabolic syndrome compared with non-exposed groups (adjusted OR (AOR) 2·94, 95 % CI 1·66, 5·27). More specifically, famine exposure during prenatal life was associated with increased waist circumference (AOR 2·27 cm, 95 % CI 0·28, 4·26), diastolic blood pressure (AOR 2·47 mmHg, 95 % CI 0·84, 4·11), TAG (AOR 0·20 mmol/l, 95 % CI 0·10, 0·28) and fasting blood glucose (AOR 0·24 mmol/l, 95 % CI 0·04, 0·43) compared with the control groups. Higher proportion of the metabolic syndrome, risky anthropometric and dyslipidaemic parameters were observed among exposed groups. This finding adds further evidence on fetal origin of adult diseases hypothesis. The finding may imply that one potential means of preventing adulthood metabolic syndrome is to optimise maternal nutrition during pregnancy.
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Hidayat K, Du X, Shi BM, Qin LQ. Foetal and childhood exposure to famine and the risks of cardiometabolic conditions in adulthood: A systematic review and meta-analysis of observational studies. Obes Rev 2020; 21:e12981. [PMID: 32048436 DOI: 10.1111/obr.12981] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/11/2019] [Indexed: 12/21/2022]
Abstract
A systematic review and meta-analysis of observational studies was performed to provide a deeper understanding of the associations between foetal and childhood exposure to famine and the risks of type 2 diabetes mellitus (T2DM), metabolic syndrome, hypertension, hyperglycaemia, dyslipidaemia, obesity, overweight, coronary heart disease, stroke, and nonalcoholic fatty liver disease (NAFLD) in adulthood. Both foetal and childhood exposure to famine were positively associated with the risks of T2DM (foetal exposure: RR 1.37, 95% CI, 1.23-1.52; childhood exposure: RR 1.33, 95% CI, 1.08-1.64), metabolic syndrome (RR 1.26, 95% CI, 1.07-1.50; RR 1.24, 95% CI, 1.13-1.35), hypertension (RR 1.30, 95% CI, 1.07-1.57; RR 1.33, 95% CI, 1.02-1.74), hyperglycaemia (RR 1.27, 95% CI, 1.11-1.45; RR 1.25, 95% CI, 1.10-1.42), dyslipidaemia (RR 1.48, 95% CI, 1.33-1.66; RR 1.27, 95% CI, 1.12-1.45), obesity (RR 1.19, 95% CI, 1.02-1.39; RR 1.13, 95% CI, 1.00-1.28), overweight (RR 1.17, 95% CI, 1.07-1.29; RR 1.07, 95% CI, 1.00-1.14), coronary heart disease (RR 1.22, 95% CI, 1.00-1.51; RR 1.21, 95% CI, 1.09-1.35), and moderate-to-severe NAFLD (RR 1.66, 95% CI, 1.07-2.57; RR 1.68, 95% CI, 1.41-1.99) in adulthood. No association was observed for the risks of stroke or mild NAFLD. Adjustments for age, alcohol, smoking, body mass index, and physical activity nullified some associations. The associations were generally stronger in women than in men. In summary, foetal and childhood exposure to famine may confer greater risks of developing certain cardiometabolic conditions in adulthood, particularly in women. The extent to which risks for cardiometabolic conditions are associated with early-life famine appears to be determined by certain factors in adulthood.
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Affiliation(s)
- Khemayanto Hidayat
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Xuan Du
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bi-Min Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
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Yao H, Li L. Famine Exposure during the Fetal Period Increased the Risk of Dyslipidemia in Female Adults. Lipids 2020; 54:301-309. [PMID: 31087414 DOI: 10.1002/lipd.12151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 03/14/2019] [Accepted: 03/29/2019] [Indexed: 01/19/2023]
Abstract
Chronic diseases are gradually becoming public health challenges around the world. This study was designed to explore the relationship between early life exposure to famine in China and the risk of dyslipidemia during adulthood. A total of 604 subjects born from 1955 to 1965 received a health checkup and completed a questionnaire survey at the health management center of the tertiary hospital in Hefei, China, in 2013. A logistic regression model was used to assess dyslipidemia in famine-exposed and nonexposed individuals. Overall, exposure to famine during the fetal (OR 1.37; 95% CI: 0.90-2.10; and p = 0.14) and childhood (OR 0.97; 95% CI: 0.67-1.41; and p = 0.89) periods did not significantly increase the risk of dyslipidemia in adulthood compared with no exposure group. For females, exposure to famine during the fetal period (OR 2.00; 95% CI: 1.03-3.86; and p = 0.04) significantly increased the risk of dyslipidemia in adulthood compared to no exposure; however, this difference was not found in males. Exposure to famine in early life leads to altered lipid distribution in adulthood, and the risk of dyslipidemia significantly increased in adult women who were exposed to famine during the fetal period. Our study further validated the relationship between famine exposure during pregnancy and increased risk of dyslipidemia in female adult offspring. This study provides a scientific basis for the prevention and control of abnormal blood lipid levels in adults.
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Affiliation(s)
- Huihui Yao
- Department of Food and Nutrition Hygiene, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, 230032, China
| | - Li Li
- Department of Food and Nutrition Hygiene, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, 230032, China
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Zhang W, Luan R. Early-life exposure to the Chinese famine of 1959-61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study. BMC Public Health 2020; 20:15. [PMID: 31906901 PMCID: PMC6945412 DOI: 10.1186/s12889-019-8017-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/28/2019] [Indexed: 01/14/2023] Open
Abstract
Background Short-term starvation has been related to hyperuricemia. However, little is known about the long-term effect of early-life exposure to famine on hyperuricemia risk in adulthood. Methods The analysis included 2383 participants from the China Health and Retirement Longitudinal Study in 2015. Hyperuricemia was diagnosed as serum uric acid ≥7 mg/dL in men and serum uric acid ≥6 mg/dL in women. Famine exposure subgroups were defined as unexposed (born between October 1, 1962, and September 30, 1964), fetal-exposed (born between October 1, 1959, and September 30, 1961), and early-childhood exposed (born between October 1, 1956, and September 1, 1958). The association between early-life famine exposure and hyperuricemia risk was assessed using multivariate logistic regression. Results The prevalence of hyperuricemia in the unexposed, fetal-exposed, and early-childhood exposed participants was 10.7, 14.1, 11.1%, respectively. Compared with unexposed and early-childhood exposed participants combined as an age-balanced control, fetal-exposed participants showed an increased risk of hyperuricemia in adulthood (OR = 1.41; 95% CI: 1.06–1.88), after adjusting for gender, marital status, famine severity, residence, smoking, drinking, BMI, hypertension, and diabetes. The famine effect on hyperuricemia was accentuated by overweight or obesity (P for interaction = 0.042). Compared with unexposed and BMI < 24 kg/m2 participants, the OR (95%CI) of hyperuricemia was 3.66 (2.13–6.30) for fetal-exposed and overweight/obesity participants. However, combined unexposed and early-childhood exposed participants as an age-balanced control, the interaction of famine exposure and BMI was not statistically significant (P for interaction = 0.054). Conclusion Famine exposure in the fetal stage was associated with an increased risk of hyperuricemia in adulthood.
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Affiliation(s)
- Wenqiang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Rongsheng Luan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China.
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Katz TA, Grimm SL, Kaushal A, Dong J, Treviño LS, Jangid RK, Gaitán AV, Bertocchio JP, Guan Y, Robertson MJ, Cabrera RM, Finegold MJ, Foulds CE, Coarfa C, Walker CL. Hepatic Tumor Formation in Adult Mice Developmentally Exposed to Organotin. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:17010. [PMID: 31939706 PMCID: PMC7015627 DOI: 10.1289/ehp5414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND Tributyltin (TBT) is a persistent and bioaccumulative environmental toxicant. Developmental exposure to TBT has been shown to cause fatty liver disease (steatosis), as well as increased adiposity in many species, leading to its characterization as an obesogen. OBJECTIVE We aimed to determine the long-term effects of developmental TBT exposure on the liver. METHODS C57BL/6J mice were exposed to a dose of TBT (0.5 mg / kg body weight per day; 3.07 μ M ) below the current developmental no observed adverse effect level (NOAEL) via drinking water, or drinking water alone, provided to the dam from preconception through lactation. Sires were exposed during breeding and lactation. Pups from two parity cycles were included in this study. Animals were followed longitudinally, and livers of offspring were analyzed by pathological evaluation, immunohistochemistry, immunoblotting, and RNA sequencing. RESULTS Developmental exposure to TBT led to increased adiposity and hepatic steatosis at 14 and 20 weeks of age and increased liver adenomas at 45 weeks of age in male offspring. Female offspring displayed increased adiposity as compared with males, but TBT did not lead to an increase in fatty liver or tumor development in female offspring. Liver tumors in male mice were enriched in pathways and gene signatures associated with human and rodent nonalcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC). This includes down-regulation of growth hormone receptor (GHR) and of STAT5 signaling, which occurred in response to TBT exposure and preceded liver tumor development. CONCLUSIONS These data reveal a previously unappreciated ability of TBT to increase risk for liver tumorigenesis in mice in a sex-specific manner. Taken together, these findings provide new insights into how early life environmental exposures contribute to liver disease in adulthood. https://doi.org/10.1289/EHP5414.
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Affiliation(s)
- Tiffany A. Katz
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | - Sandra L. Grimm
- Advanced Technology Cores, Baylor College of Medicine, Houston, Texas, USA
| | - Akhilesh Kaushal
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
| | - Jianrong Dong
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | - Lindsey S. Treviño
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
- Division of Health Equities, Department of Population Sciences, City of Hope, Duarte, California, USA
| | - Rahul K. Jangid
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | - Adriana V. Gaitán
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | - Jean-Philippe Bertocchio
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
- Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Youchen Guan
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Robert M. Cabrera
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | - Milton J. Finegold
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, USA
| | - Charles E. Foulds
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Cristian Coarfa
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
- Advanced Technology Cores, Baylor College of Medicine, Houston, Texas, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Cheryl Lyn Walker
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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Zhao F, Pan A, Yang X, Meng R, Ye Y, Wang Y, Xie Y, Pan XF, Yang CX. Bidirectional association between depressive symptoms and type 2 diabetes mellitus: The China Health and Retirement Longitudinal Study. J Diabetes Complications 2019; 33:107387. [PMID: 31331733 DOI: 10.1016/j.jdiacomp.2019.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To prospectively examine the bidirectional relationship between depressive symptoms and type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese. METHODS Participants were enrolled in 2011-2012 (Wave 1) and followed up in 2013-2014 (Wave 2) and 2015-2016 (Wave 3) in the China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated by the Chinese language version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10) at three waves. T2DM was assessed by biochemical biomarkers at Wave 1 and reported physician-diagnosis at Wave 2 and 3. Cox proportional hazards regression was applied to calculate hazard ratio (HR) and 95% confidence intervals (CIs) for the bidirectional association. RESULTS Participants with baseline depressive symptoms were 1.33 times as likely to develop T2DM (HR, 1.33; 95% CI: 1.06, 1.66), compared to their counterparts after adjusting for demographic characteristics and T2DM risk factors. The risk of T2DM increased linearly with higher severity of depression as determined by a higher CESD-10 score (P for trend ≪ 0.001). In addition, baseline T2DM was associated with increased risk of incident depressive symptoms (1.15; 1.00, 1.31) and persistent depressive symptoms (1.35; 1.03, 1.77). CONCLUSION There is a positive bidirectional association between depressive symptoms and T2DM in middle-aged and elderly Chinese.
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Affiliation(s)
- Fei Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xue Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Ruiwei Meng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Ye
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Chun-Xia Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
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Tao T, Dai L, Ma J, Li Y, Guo Z. Association between early-life exposure to the Great Chinese Famine and poor physical function later in life: a cross-sectional study. BMJ Open 2019; 9:e027450. [PMID: 31326928 PMCID: PMC6661887 DOI: 10.1136/bmjopen-2018-027450] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the association between early-life exposure to the Great Chinese Famine (1959-1961) and the prevalence of poor physical function in midlife. DESIGN A population-based historical prospective study was performed as part of a wider cross-sectional survey. Exposure to famine was defined by birthdate, and participants were divided into non-exposed group, fetal-exposed group and infant-exposed group. SETTING AND PARTICIPANTS A total of 3595 subjects were enrolled into the study from the China Health and Retirement Longitudinal Study (CHARLS) 2015 based on random selection of households that had at least one member aged 45 years old and older in 28 provinces of mainland China. MAIN OUTCOME MEASURES Physical function status was assessed by a six-item self-report on the Barthel scale which rated basic activities of daily living (BADL). RESULTS 743 (20.7%) out of all participants were exposed to the Great Chinese Famine in their fetal periods, while 1550 (43.1%) participants were exposed at the age of an infant. The prevalence of poor physical function in the non-exposed group, fetal period-exposed group and infant period-exposed group were 12.3%, 15.5% and 17.0%, respectively. Among males, after stratification by gender and severity of famine, the prevalence of poor physical function in the fetal period was significantly higher (OR 2.40, 95% CI 1.18 to 4.89, p=0.015) than the non-exposed group in severely affected areas, even after adjusting for the number of chronic diseases, place of residence, smoking and alcohol drinking habits, marital status, educational level and body mass index. A similar connection between prenatal and early postnatal exposure to the Great Chinese Famine and the prevalence of poor physical function in midlife, however, was not observed from female adults. CONCLUSIONS Males who were exposed to the Great Chinese Famine (1959-1961) present considerably decreased physical function in their later life.
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Affiliation(s)
- Tao Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Lingyan Dai
- Department of Epidemiology and Health Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - JinXiang Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yusi Li
- Department of Epidemiology and Health Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Zhuoyuan Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, China
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Shen L, Li C, Wang Z, Zhang R, Shen Y, Miles T, Wei J, Zou Z. Early-life exposure to severe famine is associated with higher methylation level in the IGF2 gene and higher total cholesterol in late adulthood: the Genomic Research of the Chinese Famine (GRECF) study. Clin Epigenetics 2019; 11:88. [PMID: 31182144 PMCID: PMC6558811 DOI: 10.1186/s13148-019-0676-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/29/2019] [Indexed: 12/19/2022] Open
Abstract
Objective To evaluate the association of early-life exposure to the Chinese Great Famine (1959–1961) with DNA methylation in IGF2 and its subsequent influence on blood lipid levels in late adulthood among participants of the Genomic Research of the Chinese Famine (GRECF) study. Methods The GRECF study recruited 790 participants born between 1956 and 1964 from 2 neighbor provinces, Anhui and Jiangxi, in China through a multistage, clustered, random sampling. The current study included a random sample of 188 GRECF participants. IGF2 differential methylation region (DMR) is an intragenic DMR located upstream of the imprinted promoters of IGF2 exon 3. DNA methylation were quantified at 8 cytosine-phosphate-guanine dinucleotides (CpG) sites at the IGF2 DMR (chr11p15.5) using the Sequenom EpiTYPER method and the MassARRAY system. Multivariate linear regressions were used to evaluate pairwise associations among famine severity, DNA methylation in the IGF2 gene, and lipid levels. We controlled for age and sex in the base model and additionally controlled for education, smoking, and drinking status in the fully adjusted model. Mediation analysis was applied to assess the mediation effect of DNA methylation at the IGF2 gene on the association between early-life exposure to severe famine and adult lipid levels. Results Exposure to severe famine was associated with elevated methylation at CpG1 (chr11: 2126041, build 36) of the IGF2 DMR (β = 0.07; P = 0.0008) and total cholesterol (β = 0.72; P = 1.09 × 10−7). After adjustment for age and sex, each unit increase in methylation of the CpG1 site was associated with 1.09-unit increase in total cholesterol (P = 0.03). After further adjustment for all covariates, these associations were still significant (Pfamine-CpG1 = 0.002, Pfamine-total cholesterol = 1.28 × 10−6, and PCpG1-total cholesterol = 0.05). Conclusion Increased methylation level in the IGF2 gene was associated with early-life exposure to severe famine, and this change was also positively associated with total cholesterol in late adulthood. Electronic supplementary material The online version of this article (10.1186/s13148-019-0676-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luqi Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Health Sciences Campus, 101 Buck Road, Athens, GA, 30602, USA
| | - Changwei Li
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Health Sciences Campus, 101 Buck Road, Athens, GA, 30602, USA
| | - Zhenghe Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Ruiyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Health Sciences Campus, 101 Buck Road, Athens, GA, 30602, USA
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Health Sciences Campus, 101 Buck Road, Athens, GA, 30602, USA
| | - Toni Miles
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Health Sciences Campus, 101 Buck Road, Athens, GA, 30602, USA
| | - Jingkai Wei
- Department of Epidemiology, School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
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Rong H, Lai X, Mahmoudi E, Fang H. Early-Life Exposure to the Chinese Famine and Risk of Cognitive Decline. J Clin Med 2019; 8:jcm8040484. [PMID: 30974821 DOI: 10.3390/jcm8040484] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/25/2022] Open
Abstract
Previous studies on the Chinese famine suggested long-term effects of early-life famine exposure on health conditions. This study aims to investigate the association between exposure to the Chinese famine of 1959-1961 at different early-life stages and the risk of cognitive decline in adulthood. A total of 6417 adults born between 1952 and 1964 in the 2015 survey data of China Health and Retirement Longitudinal Study were included in this study. Cognitive performance was estimated through a series of comprehensive neuropsychological tests, including the Telephone Interview of Cognitive Status (TICS-10), word recall, and pentagon drawing. Multiple generalized linear model (GLM) was employed to detect the association between multi-stage early-life famine exposure and late-life cognitive performance. Compared with the unexposed group, respondents exposed to famine in the fetal period performed worse in the TICS (difference -0.52, 95% confidence interval (CI): -0.93 to -0.10), word recall (difference -0.46, 95% CI: -0.74 to -0.19), and general cognition (difference -1.05, 95% CI: -1.64 to -0.47). Furthermore, we also found negative effects of famine exposure on performance of word recall and pentagon drawing in the early (word recall difference -0.56, 95% CI: -1.00 to -0.11; pentagon drawing difference -0.76, 95% CI: -1.40 to -0.12), mid (word recall difference -0.46, 95% CI: -0.81 to -0.11; pentagon drawing difference -0.66, 95% CI: -1.16 to -0.16), and late (word recall difference -0.30, 95% CI: -0.55 to -0.04; pentagon drawing difference -0.75, 95% CI: -1.13 to -0.37) childhood-exposed groups. Early-life famine exposure in different stages is positively associated with late-life cognitive decline. Fetal famine exposure might affect the overall cognitive status in adulthood, and childhood famine exposure has potential adverse effects on visuospatial episodic memory.
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Affiliation(s)
- Hongguo Rong
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Xiaozhen Lai
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Elham Mahmoudi
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
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Early-Life Exposure to the Chinese Famine Is Associated with Higher Methylation Level in the INSR Gene in Later Adulthood. Sci Rep 2019; 9:3354. [PMID: 30833584 PMCID: PMC6399294 DOI: 10.1038/s41598-019-38596-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/04/2019] [Indexed: 12/19/2022] Open
Abstract
We examined the association between the China famine exposure in early life and DNA methylation of INSR (hg18, chr19:7110130-7110574) and CPT1A (hg18, chr11: 68286513-68286952) related to growth and metabolism in 235 subjects selected from two provinces in China. The subjects were categorized into prenatal famine-exposed group and non-exposed group based on their birthdates. DNA methylation at the INSR gene locus was assayed from peripheral white blood cells using the Sequenom's MassARRAY system. Two dependent samples t-test was used to compare the difference between the exposed group and non-exposed group. DNA methylation level of INSR was higher among individuals who exposed to the China famine in the fetus than that of non-exposed group (d = 3.3%, P = 0.006). A significant interaction between famine exposure and province was observed for INSR (Pinteraction < 0.001). DNA methylation level of INSR was positively associated with triglyceride (β = 0.011, P = 0.021), and negatively associated with high-density lipoprotein cholesterol (β = -0.039, P = 0.021). Moreover, exposed group had higher meat consumption than non-exposed group in severe exposure area. Prenatal exposure to the China famine plus later life eating habits might regulate epigenome.
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Ning F, Ren J, Song X, Zhang D, Liu L, Zhang L, Sun J, Zhang D, Pang Z, Qiao Q, Diabetes Prevention Program OBOQ. Famine Exposure in Early Life and Risk of Metabolic Syndrome in Adulthood: Comparisons of Different Metabolic Syndrome Definitions. J Diabetes Res 2019; 2019:7954856. [PMID: 31886286 PMCID: PMC6925820 DOI: 10.1155/2019/7954856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/21/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022] Open
Abstract
This study examined the association between famine exposure in early life and the risk of metabolic syndrome (MetS) in adulthood during the 1959-1961 Chinese Famine. Two cross-sectional surveys involving randomly selected Chinese adults aged 35-74 years in the Qingdao area were conducted. A total of 9,588 individuals were grouped into four birth cohorts of unexposed (born between January 1, 1962, and December 31, 1975), fetal-exposed (born between January 1, 1959, and December 31, 1961), childhood-exposed (born between January 1, 1949, and December 31, 1958), and adolescence/adult-exposed cohorts (born between January 1, 1931, and December 31, 1948). We assessed the prevalence rate of MetS in relation to famine exposure according to three definitions of MetS by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF), and China Diabetes Society (CDS). According to the CDS criterion, the prevalence rates of MetS were 17.8%, 25.7%, 31.1%, and 45.3% in the unexposed, fetal-, childhood-, and adolescence/adult-exposed cohorts, respectively (P < 0.001). For the CDS criteria, compared with individuals without famine exposure, odds ratios (95% confidence interval) for MetS were 1.36 (1.02-1.81), 1.36 (1.06-1.75), and 1.60 (1.06-2.41) in women and 1.10 (0.79-1.53), 1.07 (0.79-1.42), and 1.21 (0.74-1.99) in men who were exposed in the fetal, childhood, and adolescence/adult periods, respectively, after adjustment for age, study cohorts, residential areas, education levels, income levels, current smoking, and current drinking. The same trend was observed in fetal and childhood exposure for the NCEP-ATP III and IDF definitions, except for a marginal effect in adolescence/adult exposure. Sensitivity analysis revealed that the odds ratios for MetS prevalence for the CDS definition were 1.37 (1.03-1.82), 1.40 (1.09-1.79), and 1.58 (1.04-2.40) among fetal, childhood, and adolescence/adult exposure in rural areas, respectively. The CDS definition is superior to the other definitions for determining the association between famine exposure and MetS with respect to early life. Famine exposure in early life is associated with an increased risk of MetS in later life, especially in women. Early-life malnutrition and later life overnutrition were critical in determining adulthood metabolic disorders.
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Affiliation(s)
- Feng Ning
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, 266021 Qingdao, China
- Qingdao Centers for Disease Control and Prevention, 266033 Qingdao, China
- Qingdao Institute of Preventive Medicine, 266033 Qingdao, China
| | - Jie Ren
- Shandong Centers for Disease Control and Prevention, 250200 Jinan, China
| | - Xin Song
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, 266021 Qingdao, China
- Qingdao Centers for Disease Control and Prevention, 266033 Qingdao, China
- Qingdao Institute of Preventive Medicine, 266033 Qingdao, China
| | - Dong Zhang
- Huangdao Centers for Disease Control and Prevention, 266000 Qingdao, China
| | - Li Liu
- Qingdao Centers for Disease Control and Prevention, 266033 Qingdao, China
- Qingdao Institute of Preventive Medicine, 266033 Qingdao, China
| | - Lei Zhang
- Qingdao Endocrine and Diabetes Hospital, 266003 Qingdao, China
- Weifang Medical College, 261000 Weifang, China
| | - Jianping Sun
- Qingdao Centers for Disease Control and Prevention, 266033 Qingdao, China
- Qingdao Institute of Preventive Medicine, 266033 Qingdao, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, 266021 Qingdao, China
| | - Zengchang Pang
- Qingdao Centers for Disease Control and Prevention, 266033 Qingdao, China
- Qingdao Institute of Preventive Medicine, 266033 Qingdao, China
| | - Qing Qiao
- Department of Public Health, University of Helsinki, FI-00014 Helsinki, Finland
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Wang Z, Zou Z, Yang Z, Dong Y, Song J, Dong B, Ma J, Arnold L. The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study. BMC Public Health 2018; 18:1205. [PMID: 30367620 PMCID: PMC6204016 DOI: 10.1186/s12889-018-6134-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 10/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The associations of famine exposure with diabetes risk in adulthood are still unclear. This study aimed to explore the association between famine exposure in early life and risk of diabetes in adulthood. METHODS A total of 4138 subjects were selected from the data of the China Health and Retirement Longitudinal Study (CHARLS) 2011-2012. Diabetes was diagnosed as fasting plasma glucose (FPG) ≥7.0 mmol/L, glycated haemoglobin (HbA1C) > 6.5%, or self-reported diabetes. Birthdates of subjects were used to categorize famine exposure groups. The association of fetal-stage famine exposure with diabetes risk in adults was assessed using logistics regression model. RESULTS The prevalence of diabetes in the non-exposed, fetal-stage exposed, infant-stage exposed, and preschool-stage exposed groups were 9.0, 13.6, 12.7 and 10.8%, respectively. Compared with the age-balanced control group, the fetal-stage exposed group was associated with the elevated risk of diabetes in later life after adjusting for covariates (OR = 1.37; 95%CI: 1.09-1.72; P = 0.008). Stratified analysis showed that the association between prenatal famine exposure and diabetes risk in adulthood was comparable between severely affected areas and less severely affected areas (P for interaction =0.153). CONCLUSIONS Famine exposure in fetal stages was associated with the elevated diabetes risk in adults, which could be the critical periods for relative intervention.
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Affiliation(s)
- Zhenghe Wang
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Zhiyong Zou
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Zhongping Yang
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Yanhui Dong
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Jieyun Song
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Bin Dong
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
| | - Jun Ma
- School of Public Health & Institute of Child and Adolescent Health, Peking University, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
| | - Luke Arnold
- Population Health & South Western Sydney Primary Health Network, Sydney, NSW, Australia
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Whittaker C, Frühauf A, Burthem SJ, Parry RS, Kotikalapudi M, Liang Y, Barker MM, Patel PR, Kelman I. A disaster diplomacy perspective of acute public health events. DISASTERS 2018; 42 Suppl 2:S173-S195. [PMID: 30080259 DOI: 10.1111/disa.12306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Conceptions of acute public health events typically assume that they are tackled exclusively or principally through technical and medical solutions. Yet health and politics are inexorably linked. To better understand this link, this paper adopts a disaster diplomacy perspective for analysing and assessing the impacts of acute public health events on diplomatic outcomes. Two gaps in understanding disaster-health-politics connections are addressed: (i) how health interventions can impact diplomatic endeavours, especially for (ii) acute public health events. Three diverse case studies are interpreted from a disaster diplomacy perspective: Cuba's medical diplomacy, China and Severe Acute Respiratory Syndrome (SARS), and polio vaccination. Disaster diplomacy permits deeper investigation and analysis of connections amongst health, disaster, and diplomatic activities by viewing efforts on acute public health events as being political through disaster risk reduction (beforehand) and disaster response (during and afterwards). Understanding improves how health interventions affect diplomacy and on disaster diplomacy's limitations.
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Affiliation(s)
- Charlie Whittaker
- PhD student at the School of Public Health, Imperial College London, United Kingdom
| | - Anna Frühauf
- MSc Public Health student at the Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Samuel John Burthem
- MSc student at the School of Public Policy, University College London, United Kingdom
| | | | - Meghana Kotikalapudi
- MBBS MSc student at the Faculty of Medical Sciences, Newcastle University, United Kingdom
| | - Yihui Liang
- MPH student at the School of Public Health, Imperial College London, United Kingdom
| | - Mary Moffett Barker
- PhD student at the Department of Health Sciences, University of York, United Kingdom
| | - Parth Rohit Patel
- MB BChir student at the School of Clinical Medicine, University of Cambridge, United Kingdom
| | - Ilan Kelman
- Reader at University College London, United Kingdom, and Professor II at the University of Agder, Norway
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Wang Z, Zou Z, Dong B, Ma J, Arnold L. Association between the Great China Famine exposure in early life and risk of arthritis in adulthood. J Epidemiol Community Health 2018; 72:790-795. [PMID: 29680802 DOI: 10.1136/jech-2017-210334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/05/2018] [Accepted: 04/06/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND The association between famine exposure in early life and risk of arthritis (combination of osteoarthritis and inflammatory arthritis) in adulthood is unclear. The aim of this study is to explore the association. METHODS A total of 4124 subjects were selected from the national data of the China Health and Retirement Longitudinal Study in 2011-2012. Doctor-diagnosed arthritis was self-reported in participants' questionnaire. Birthdates were used to categorise participants into famine-exposed and non-exposed groups. Logistic regression model was used to explore the association of famine exposure in early life with the risk of arthritis in adulthood. RESULTS The prevalence of arthritis in both infant-exposed and preschool-exposed groups was significantly higher than those in the non-exposed group (35.0% and 30.6% vs 27.3%; p<0.05). Compared with the non-exposed group, the infant-exposed group showed a significantly elevated risk of arthritis in adulthood after adjusting for confounding factors (OR=1.65; 95% CI 1.29 to 2.11; p<0.001). In the stratified analysis, we found that participants who lived in severely affected areas (OR=1.91; 95% CI 1.41 to 2.59; p<0.001), who are female (OR=2.21; 95% CI 1.57 to 3.11; p<0.001) and those with a body mass index ≥24.0 kg/m2 (OR=2.46; 95% CI 1.70 to 3.55; p<0.001) in the infant-exposed group had increased risk of arthritis in adulthood. Similar results were additionally observed when age-balanced control group was used. CONCLUSION Great China Famine exposure in infancy may be associated with an elevated risk of arthritis in adulthood, particularly in women and participants with adiposity. These findings suggest nutrition intervention in infancy and weight control in later life may reduce the risk of arthritis in adulthood.
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Affiliation(s)
- Zhenghe Wang
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Zhiyong Zou
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Bin Dong
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Jun Ma
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Luke Arnold
- Population Health, South Western Sydney Primary Health Network, Sydney, New South Wales, Australia
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Chang X, Song P, Wang M, An L. The Risks of Overweight, Obesity and Abdominal Obesity in Middle Age after Exposure to Famine in Early Life: Evidence from the China's 1959-1961 Famine. J Nutr Health Aging 2018; 22:1198-1204. [PMID: 30498826 DOI: 10.1007/s12603-018-1144-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Several studies have revealed that exposure to famine in early life was associated with higher body mass index(BMI) and waist circumference, and most of them used data from cross-sectional studies and defined those born before or after the famine period as non-exposed participants, which ignored the effects caused by age. Our objective was to study the effects of undernutrition in early life on overweight, obesity and abdominal obesity in those aged 54-56. METHODS This was a retrospective cohort study with the status at age of 54-56 as outcomes. 1092 participants born between 1959 and 1961 from 2015 wave of China Health and Retirement Longitudinal Study (CHARLS) were defined as exposed and 1616 born between 1955 and 1957 from 2011 wave of CHARLS were defined as control. We used the prevalence odds ratios(ORs) to estimate the risks of overweight, obesity, abdominal obesity, and stratified by famine severity and sex separately for comparisons. RESULTS Exposed group had higher risks of overweight (OR 1.357, 95%CI 1.067,1.727) and obesity (OR 1.356, 95%CI 1.001,1.836) in women, not in men. Participants in exposed group were more likely to have abdominal obesity (OR 1.362, 95%CI 1.139,1.629), regardless of famine severity and gender. CONCLUSION Undernutrition in early life increased the risks of overweight and obesity in women not in men. And the risk of abdominal obesity was increased with the experience of undernutrition at early age both in men and women.
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Affiliation(s)
- X Chang
- Lin An, Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China,
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One-Carbon Metabolism and Lipid Metabolism in DOHaD. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1012:3-9. [DOI: 10.1007/978-981-10-5526-3_1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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