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Li X, Li X, Sun L, Yang L, Wang C, Yuan T, Lei Y, Li J, Liu M, Zhang D, Hua Y, Liu H, Zhang L. Individual and combined effects of famine exposure and obesity parameters on type 2 diabetes in middle-aged and older adults: A population-based cross-sectional study. Medicine (Baltimore) 2024; 103:e39228. [PMID: 39121280 PMCID: PMC11315537 DOI: 10.1097/md.0000000000039228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 07/18/2024] [Indexed: 08/11/2024] Open
Abstract
Malnutrition early in life may have adverse effects on health later in life. The relationship between malnutrition and obesity parameters (body mass index [BMI] and waist circumference [WC]) and type 2 diabetes is inconsistent. This study aimed to identify the effects of famine exposure and obesity parameters on type 2 diabetes individually or in combination among middle-aged and older adults in China. Data were extracted from the China Health and Retirement Longitudinal Study Wave1 in 2011. The sample involved 13,065 adults aged 45 to 90. The t- or F test was employed to compare age among groups. The chi-square test was utilized to compare baseline characteristics according to the categorical WC levels/BMI levels/famine exposure and examine between-group differences in type 2 diabetes (diabetes and non-diabetes). Odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression models to estimate the individual and combined associations of BMI/WC levels and famine exposure with the prevalence of type 2 diabetes. In this study, 1559 (11.93%) individuals were exposed to Chinese famine during their fetal stage, 5132 (39.28%) and 4428 (33.89%) in childhood and adolescence/adulthood, respectively. Among BMI measurements, 3780 (28.93%) were overweight, and 1487 (11.38%) were obese, whereas WC measurements showed that 5408 (41.39%) were obesity. In addition, 831 (45.48%) males and 996 (54.52%) females reported type 2 diabetes. In multivariable-adjusted regression models, obesity parameters and famine exposure were independently associated with type 2 diabetes prevalence among all participants (P < .001). In the interaction analysis, there existed a trend of higher odds for prevalence of type 2 diabetes across all groups compared to the combination of no-exposed and normal BMI/WC level group (the most increase in odds, adolescence/adulthood-exposed group with central obesity in WC levels: OR 4.51 (95% CI = 3.42-5.95); adolescence/adulthood-exposed group with obesity in BMI levels: OR 5.84 (95% CI = 4.11-8.30; P for interaction <.001). The findings for females exhibited similar to the overall participants, when by gender stratification. Our results suggest famine exposure and obesity parameters have positive combined effects on type 2 diabetes in middle-aged and older adults in China.
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Affiliation(s)
- Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Xiaoguang Li
- National Center for Occupational Safety and Health, National Health Commission of the People’s Republic of China, Beijing, P.R.China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu City, An Hui Province, P.R.China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu City, An Hui Province, P.R.China
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Xiong H, Liu D, Tang D, Ma F. Exposure to Chinese famine and the risk of hyperuricemia in later life: a population-based cross-sectional study. Front Nutr 2024; 11:1266817. [PMID: 38298423 PMCID: PMC10828035 DOI: 10.3389/fnut.2024.1266817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
Background Limited studies have investigated the relationship between famine exposure and the risk of hyperuricemia in later life. Consequently, the primary purpose of the current study was to examine the potential association between exposure to Chinese famine and hyperuricemia, as well as any gender disparities in this relationship. Method The data were obtained from the China PEACE (China Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project in Rongchang. The study participants were enrolled into different cohorts based on their birthdates: the fetal-exposed cohort (born between 1959 and 1962), the childhood-exposed cohort (born between 1949 and 1958), the adolescence-exposed cohort (born between 1941 and 1948), and the non-exposed cohorts (born between 1963 and 1974). The potential association between famine exposure and hyperuricemia was assessed using binary logistic regression models. Results A total of 6,916 individuals were enrolled in the current study with an average age of 60.11 ± 9.22 years, out of which 3,544 were women. After adjusting for confounding factors, fetal (OR = 0.530, 95% CI: 0.411-0.0.683), childhood (OR = 0.642, 95% CI: 0.494-0.833) exposure to the Chinese famine for men was negatively associated with hyperuricemia. Conversely, exposure to the Chinese famine during fetal (OR = 2.144, 95% CI: 1.622-2.834), childhood (OR = 1.485, 95% CI: 1.105-1.997), and adolescence (OR = 1.967, 95% CI: 1.465-2.641) for women was positively associated with hyperuricemia. Furthermore, the impact of famine on hyperuricemia that has been observed in exposed women might be intensified by the presence of dyslipidemia, abdominal obesity, and overweight/obesity. Conclusion Women exposed to the Chinese famine during fetal, childhood, and adolescence were positively associated with hyperuricemia, while men exhibited a negative association during fetal and childhood. Additionally, the effect of famine on hyperuricemia in exposed women appears to be intensified by the presence of dyslipidemia, abdominal obesity, and overweight/obesity.
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Affiliation(s)
- Huali Xiong
- Department of Public Health, Health Commission of Rongchang District, Chongqing, China
| | - Daiqiang Liu
- Department of Hospital Information, The People's Hospital of Rongchang District, Chongqing, China
| | - Dayi Tang
- First Clinical College, Mudanjiang Medical College, Mudanjiang, Heilongjiang, China
| | - Fengxun Ma
- Department of Public Health, Health Commission of Rongchang District, Chongqing, China
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Liu C, Zhu S, Zhang J, Wu P, Wang X, Du S, Wang E, Kang Y, Song K, Yu J. Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis, 1990-2019: a decomposition and age-period-cohort analysis. J Gastroenterol 2023; 58:1222-1236. [PMID: 37665532 DOI: 10.1007/s00535-023-02040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Identifying past temporal trends in non-alcoholic steatohepatitis (NASH)-associated liver cancer (NALC) can increase public awareness of the disease and facilitate future policy development. METHODS Annual deaths and age-standardized death rates (ASDR) for NALC from 1990 to 2019 were collected from the Global Burden of Disease (GBD) 2019 study. The long-term trend and the critical inflection of mortality of NALC were detected by Joinpoint analysis. Age-period-cohort analysis was employed to evaluate the effects of age, period, and cohort. Last, decomposition analysis was used to reveal the aging and population growth effects for NALC burden. RESULTS Between 1990 and 2019, the ASDR of NALC witnessed an overall declining trend on a global scale, with a decrease in females and a stable trend in males. However, the global ASDR demonstrated a significant upward trend from 2010 to 2019. Southern sub-Saharan Africa and Southeast Asia have the highest NALC burdens, while high socio-demographic index (SDI) region experienced the fastest escalation of NALC burdens over 30 years. The decomposition analysis revealed that population growth and aging were the primary catalysts behind the increase in global NALC deaths. Age-period-cohort analyses showed that NALC mortality declined the fastest among females aged 40-45 years in high SDI region, accompanied by a deteriorating period effect trend during the period of 2010-2019. CONCLUSION The global absolute deaths and ASDR of NALC have witnessed a rise in the past decade, with populations exhibiting considerable disparities based on sex, age, and region. Population growth, aging, and metabolism-related factors were the main factors behind the increase in global NALC deaths.
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Affiliation(s)
- Chunlong Liu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, 236000, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Jian Zhang
- Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun, 113001, China
| | - Panpan Wu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, 236000, China
| | - Xuan Wang
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, 236000, China
| | - Sen Du
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Bengbu Medical College, Fuyang, 236000, China
| | - Enzhao Wang
- Graduate School, Wannan Medical College, Wuhu, 241000, Anhui, China
| | - Yunkang Kang
- Department of Orthopedics, Fuyang People's Hospital, Anhui Medical University, Anhui Medical University, Fuyang, 236000, China
| | - Kun Song
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, 236000, China.
- Graduate School, Wannan Medical College, Wuhu, 241000, Anhui, China.
| | - Jiangtao Yu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, 236000, China.
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Bengbu Medical College, Fuyang, 236000, China.
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Prenatal exposure to famine and the development of diabetes later in life: an age-period-cohort analysis of the China health and nutrition survey (CHNS) from 1997 to 2015. Eur J Nutr 2023; 62:941-950. [PMID: 36326864 DOI: 10.1007/s00394-022-03049-w] [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: 04/25/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Prenatal exposure to famine has been linked to increased diabetes risk in adulthood. However, one fundamental issue to be addressed is that the reported famine-diabetes relation may be confounded by the age differences between the exposed and non-exposed groups. We aimed to determine the association between prenatal exposure to the Chinese famine of 1959-1962 and risk of diabetes by applying age well-controlled strategies. METHODS Among 20,535 individuals born in 1955-1966 who participated in the China Health and Nutrition Survey from 1997 to 2015, we constructed age-matched exposed vs. non-exposed groups to investigate the role of prenatal exposure to the Chinese famine of 1959-1962 in relation to diabetes. We also built a hierarchical age-period-cohort (HAPC) model to specifically examine the relation of famine to diabetes risk independent of age. RESULTS Compared to the age-balanced men in the non-exposed group, the exposed men born in 1961 had a 154% increased risk of diabetes [odds ratio (OR) 2.54 (95% CI 1.07-6.03), P = 0.04). In the HAPC analysis, the predicted probabilities of diabetes peaked in the 1961-birth cohort of men [3.4% (95% CI 2.4%-5.0%)], as compared to the average probability of diabetes (reference) of 1.8% for men overall. Neither analytical strategy revealed any strong relation between famine exposure and diabetes risk in women. CONCLUSION Among the pre-defined Chinese famine period of 1959-1962, early-life exposure to famine was associated with increased diabetes risk in men but not in women, and these relations were independent of age.
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Arage G, Belachew T, Abate KH. Early life famine exposure and anthropometric profile in adulthood: a systematic review and Meta-analysis. BMC Nutr 2022; 8:36. [PMID: 35459231 PMCID: PMC9028079 DOI: 10.1186/s40795-022-00523-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Previous famine studies reported the association between early life famine exposure and adulthood anthropometric profile. However, the findings were variable. Thus, a systematic review and meta-analysis was conducted to clarify the association of famine exposure in early life with the anthropometric profiles in adults. Methods Potentially relevant studies were searched through Scopus, Medline, Google Scholar and Google for gray literature and reference lists of previous studies. The random effects model (REM) and I2 test was used to adapt the pooling method and assess heterogeneity, respectively. Results Prenatal famine exposure was associated with increased risk of body mass index [SMD = 0.10 (95% CI: 0.02, 0.18)], waist circumference [SMD = 0.21 (95% CI: 0.11, 0.31)] in adults. Likewise, famine exposure during prenatal life was associated with decreased adult height [SMD) = − 0.26 (95% CI: − 0.44, − 0.09)]. Moreover, famine exposure during early childhood was associated with increased risk of waist circumference [SMD = 0.09 (95% CI: 0.01, 0.16)] and decreased adult height [SMD = − 0.16 (95% CI: − 0.27, − 0.04)]. Conclusion Our finding indicates that exposure to famine during early life was associated with the anthropometric profile of adults. In terms of public health significance, the results of the study further underscore the importance of improving the nutritional status of mothers and children to prevent adulthood diseases in the long run. Systematic review registration number PROSPERO CRD42020168424 Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00523-w.
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Affiliation(s)
- Getachew Arage
- Department of Nutrition and Dietetics, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia. .,Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kalkidan Hassen Abate
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
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Sun P, Wen H, Liu X, Ma Y, Jang J, Yu C. Time trends in type 2 diabetes mellitus incidence across the BRICS from 1990 to 2019: an age-period-cohort analysis. BMC Public Health 2022; 22:65. [PMID: 35012503 PMCID: PMC8751323 DOI: 10.1186/s12889-021-12485-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The incidence rate of type 2 diabetes mellitus (T2DM) is rapidly increasing in Brazil, Russia, India, China, and South Africa (BRICS). The present study analyzed trends in T2DM incidence rate across the BRICS and associations with age, period, and birth cohort. METHODS The incidence rate was estimated by the data obtained from GBD 2019 (Global Burden of Disease Study 2019) and was analyzed with the age-period-cohort framework. Incidence rates of T2DM (1990-2019) were collected for each 5-year age group (from 25 to 29 to 85-89 age group) stratified by gender from the Global Burden of Disease 2019 Study. RESULTS In 2019, the the incidence rate of T2DM was 280.2 per 100,000 across the BRICS. Between 1990 and 2019, the incidence rate of T2DM among the BRICS population increased by 83.3%. In each period, as age increases, the incidence rate of T2DM in China and Russia first increased and then decreased, while the incidence rate of T2DM in Brazil, India and South Africa first increased and then decreased slightly with age group. Deteriorating period and cohort risks for incidence rate of T2DM were generally found across the BRICS. CONCLUSIONS The number of diabetic patients in the BRICS countries has continued to increase and the growth rate has been stable in the past 30 years, which is dependent on age and some other environmental factors. Some possible factors influencing T2DM incidence are analyzed and hypotheses generated through the age and period effects.
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Affiliation(s)
- Panglin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, #115 Donghu Road, Wuhan, 430071 China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, #115 Donghu Road, Wuhan, 430071 China
| | - Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, #115 Donghu Road, Wuhan, 430071 China
| | - Yudiyang Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, #115 Donghu Road, Wuhan, 430071 China
| | - Jie Jang
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, Hubei China
- Global Health Institute, Wuhan University, #8 Donghu Road, Wuchang District, Wuhan, 430072 China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, #115 Donghu Road, Wuhan, 430071 China
- Global Health Institute, Wuhan University, #8 Donghu Road, Wuchang District, Wuhan, 430072 China
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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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Li J, Yang Q, An R, Sesso HD, Zhong VW, Chan KHK, Madsen TE, Papandonatos GD, Zheng T, Wu WC, Song Y, Yu X, Liu S. Famine and Trajectories of Body Mass Index, Waist Circumference, and Blood Pressure in Two Generations: Results From the CHNS From 1993-2015. Hypertension 2021; 79:518-531. [PMID: 34872333 DOI: 10.1161/hypertensionaha.121.18022] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Early-life exposures play key roles in the development of metabolic diseases. Whether such effects exist beyond one generation remains unclear. This study aimed to determine the transgenerational association of early-life exposure to the Chinese famine of 1959 to 1962 with the trajectories of body mass index (BMI), waist circumference (WC), and blood pressure (BP) in 2 consecutive generations. We included 21 106 F1 observations born between 1954 and 1967 (median age: 45 years) and 1926 F2 observations (median age: 23 years) from the longitudinal household-based China Health and Nutrition Survey from 1993 to 2015. Trajectories of BMI, WC, systolic BP, and diastolic BP were fitted and compared between groups using linear mixed effect models. Early-life exposure to famine was associated with increased BMI, WC, and BP in 2 consecutive generations with sex and age disparities. In F1, famine was associated with increased BMI, WC, systolic BP, and diastolic BP, especially in men or those aged older than 50 years (P ranged from <0.001 to 0.02). In F2 men but not women, the parental exposure to famine was associated with 0.59 kg/m2 ([95% CI, 0.10-1.08], P=0.02) increase in BMI. In F2 aged ≥25 years but not those younger ones, the parental exposure to famine was associated with increased BMI (0.83 kg/m2 [0.14-1.51], P=0.03), systolic BP (2.04 mm Hg [0.20-3.88], P=0.03), and diastolic BP (1.73 mm Hg [0.28-3.18], P=0.02). The effects of an adverse developmental environment through famine in early life on BMI and BP later in life may persist beyond one generation.
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Affiliation(s)
- Jie Li
- From the Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (J.L., Q.Y., X.Y.).,Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.)
| | - Qingling Yang
- From the Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (J.L., Q.Y., X.Y.)
| | - Ran An
- Medical Research Center, Division of Laboratory Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (R.A.)
| | - Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (H.D.S.)
| | - Victor W Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, China (V.W.Z.)
| | - Kei Hang Katie Chan
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.).,Departments of Biomedical Sciences and Electrical Engineering, City University of Hong Kong, Hong Kong SAR, China (K.H.K.C.)
| | - Tracy E Madsen
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.).,Department of Emergency Medicine, The Warren Alpert Medical School, Brown University, Providence, RI (T.E.M.)
| | - George D Papandonatos
- Department of Biostatistics, School of Public Health, Brown University, Providence, RI (G.D.P.)
| | - Tongzhang Zheng
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.)
| | - Wen-Chih Wu
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.).,Departments of Medicine and Surgery, The Warren Alpert Medical School, Brown University, Providence, RI (W.-C.W., S.L.)
| | - Yan Song
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.)
| | - Xueqing Yu
- From the Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (J.L., Q.Y., X.Y.).,Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (X.Y.)
| | - Simin Liu
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI (J.L., K.H.K.C., T.E.M., T.Z., W.-C.W., Y.S., S.L.).,Departments of Medicine and Surgery, The Warren Alpert Medical School, Brown University, Providence, RI (W.-C.W., S.L.)
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Li Y, Sunder N. What doesn't kill her, will make her depressed. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101064. [PMID: 34601324 DOI: 10.1016/j.ehb.2021.101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/04/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
In this paper we study the long run effects of the 1959-61 Chinese Famine on mental health outcomes. We focus on cohorts that were born during the famine and examine their mental health as adults, when they are roughly 55 years of age. We find that early-life exposure to this famine leads to a large statistically significant negative impact on women's mental health, while there is limited effect on men. This gender differential effect is observed because male fetuses experience a stronger natural selection as compared to female fetuses, which implies that in the longer run, surviving females may exhibit larger detrimental effects of early-life famine exposure. Thus, the observed effects are a composite of two well-established factors, the survival of the fittest and the Fetal Origins hypothesis.
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Affiliation(s)
- Yanan Li
- Business School, Beijing Normal University, 1720 Houzhu Building, No. 19 XinJieKouWai Street, Haidian District, Beijing 100875, China.
| | - Naveen Sunder
- Department of Economics, Bentley University, AAC Room 187, 175 Forest St., Waltham, MA, 02452, United States.
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Zhang L, Yang L, Wang C, Yuan T, Zhang D, Wei H, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Li Y. Combined Effect of Famine Exposure and Obesity Parameters on Hypertension in the Midaged and Older Adult: A Population-Based Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5594718. [PMID: 34604385 PMCID: PMC8486537 DOI: 10.1155/2021/5594718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/07/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Undernutrition early in life may increase the incidence of adverse effects on adult health. The relations between undernutrition and obesity parameters (body mass index (BMI) and WC (waist circle)) and hypertension were often contradictory. Our study is aimed at identifying the combined effects of famine exposure and obesity parameters on hypertension in middle-aged and older Chinese. DESIGN A population-based cross-sectional study. Setting. Data were selected from the China Health and Retirement Longitudinal Study Wave2011 (CHARLS Wave2011). Participants. The sample included 12945 individuals aged 45 to 96. Main Outcome Measurements. The study analyzed data from 12945 middle-aged and older Chinese selected from CHARLS Wave2011. Differences between baseline characteristics and famine exposure/BMI levels/WC levels were evaluated using the t-, Chi-square- (χ 2-), and F-test. Then, the difference in the prevalence of hypertension between baseline characteristics was estimated by the t- and χ 2-test. Finally, multivariable-adjusted logistic regression models were used to explore the associations of famine exposure and obesity parameters with odds of prevalence of hypertension. RESULTS Among the 12945 participants, 1548 (11.96%) participants had been exposed to the Chinese famine during the fetal group, whereas 5101 (39.41%) participants and 4362 (33.70%) participants had been exposed to the famine during childhood and adolescence/adult group, respectively. Regarding the participants with BMI levels, 3746 (28.94%) were overweight, and 1465 (11.32%) were obese, whereas 5345 (41.29%) of the participants with WC levels were obese, respectively. Furthermore, 1920 (31.17%) had hypertension in males and 2233 (32.91%) in females. In multivariable-adjusted models, famine exposure and obesity parameters were related with prevalence of hypertension independently in total populations ((1) model threec, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.27; 95% CI 1.08, 1.49); childhood-exposed vs. no-exposed group (OR1.64; 95% CI 1.44, 1.87); the adolescence/adult-exposed vs. no-exposed group (OR3.06; 95% CI 2.68, 3.50); P for trend < 0.001; (2) model threee, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.25; 95% CI 1.06, 1.47); childhood-exposed vs. no-exposed group (OR1.52; 95% CI 1.34, 1.73); the adolescence/adult-exposed vs. no-exposed group (OR2.66; 95% CI 2.33, 3.03); P for trend < 0.001; (3) model threeg, BMI levels with prevalence of hypertension: overweight vs. normal (OR1.75; 95% CI 1.60, 1.91); obesity vs. normal (OR2.79; 95% CI 2.48, 3.15); P for trend < 0.001; (4) WC levels with prevalence of hypertension: overweight vs. normal (OR1.42; 95% CI 1.36, 1.48)). When stratified by sex, results in both males and females were mostly similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal BMI/WC levels and no-exposed famine group, all groups trended towards higher odds of prevalence of hypertension (the greatest increase in odds, adolescence/adult-exposed group with obesity in BMI levels: (OR8.13; 95% CI 6.18, 10.71); adolescence/adult-exposed group with obesity in WC levels: (OR6.36; 95% CI 5.22, 7.75); P for interaction < 0.001). When stratified by sex, the results in both males and females were also similar to those in the total population. CONCLUSION Our data support a strongly positive combined effect of famine exposure and obesity parameters on hypertension in middle-aged and elderly Chinese.
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Affiliation(s)
- Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, 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, Anhui Province, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province, China
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
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Exposure to the Great Famine in Early Life and the Risk of Obesity in Adulthood: A Report Based on the China Health and Nutrition Survey. Nutrients 2021; 13:nu13041285. [PMID: 33919739 PMCID: PMC8070734 DOI: 10.3390/nu13041285] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022] Open
Abstract
Intrauterine malnutrition has a long-term effect on human health. This study aimed to evaluate the associations between exposure to famine in early life and obesity in adulthood in Chinese adults. A total of 5033 participants (22,132 observations) of the China Health and Nutrition Survey (CHNS) in 1991–2015 were classified into three famine exposure groups according to their birth year: unexposed (1963–1966), fetal-exposed (1959–1962) and childhood-exposed (1955–1958). Compared with the unexposed group, the fetal-exposed group had higher levels of body-mass-index (BMI) and waist-circumference (WC), and higher prevalence of overweight and central obesity, whereas the childhood-exposed group had lower levels of the measurements. However, the positive associations of fetal exposure with BMI, WC and prevalence of overweight and central obesity were attenuated by additionally adjusting for age at survey. Stratified analysis showed that the adverse effect of fetal exposure to famine was only observed in subjects at several specific age-groups, and in men living in rural areas and in women living in more severe famine exposed areas (p for interaction < 0.05). Our results provide evidence for the weak effect of fetal exposure to famine on body measurements in adulthood, and suggest the importance of severity of famine exposure and timing of exposure.
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Li C, Kang B, Zhang T, Gu H, Man Q, Song P, Liu Z, Chen J, Wang X, Xu B, Zhao W, Zhang J. High Visceral Fat Area Attenuated the Negative Association between High Body Mass Index and Sarcopenia in Community-Dwelling Older Chinese People. Healthcare (Basel) 2020; 8:healthcare8040479. [PMID: 33198340 PMCID: PMC7712146 DOI: 10.3390/healthcare8040479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 01/05/2023] Open
Abstract
The association between obesity and sarcopenia remains controversial. The present study was conducted to explore the associations among body mass index (BMI), visceral fat area (VFA), and sarcopenia in older people and analyze their potential mechanisms. This cross-sectional study included 861 community-dwelling older Chinese people from three regions of China. BMI, VFA, muscle mass, muscle strength, physical performance, body composition, and metabolic markers were measured. Muscle mass and muscle strength were positively correlated with BMI, but were negatively correlated with VFA. Simple overweight/obesity was negatively associated with sarcopenia (OR = 0.07, 95% CI = 0.03~0.18), and the OR value was lower than combined obesity (OR = 0.16, 95% CI = 0.09~0.28). Fat free mass and total body protein were positively associated with high BMI but negatively associated with high VFA. Furthermore, high VFA was adversely associated with some metabolic risk factors of sarcopenia. Combination of BMI and VFA increased diagnostic efficiency of low muscle mass and sarcopenia. In conclusion, high BMI was negatively associated with sarcopenia, while high VFA attenuated the negative association between high BMI and sarcopenia. The opposite association may partially be attributed to their different associations with body composition and metabolic risk factors of sarcopenia. Therefore, bedsides BMI, VFA and its interaction with BMI should be considered in sarcopenia prevention.
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Affiliation(s)
- Cheng Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Bingxian Kang
- Wuyuan County Center for Disease Control and Prevention, 105 Shiji Road, Wuyuan, Inner Mongolia 015100, China; (B.K.); (X.W.)
| | - Ting Zhang
- Yuexiu District Center for Disease Control and Prevention, 23 Jiaochang West Road, Guangzhou 510030, China; (T.Z.); (B.X.)
| | - Hongru Gu
- Taicang City Center for Disease Control and Prevention, 36 Xianfu West Street, Taicang 215400, China;
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Pengkun Song
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Zhen Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Jingyi Chen
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Xile Wang
- Wuyuan County Center for Disease Control and Prevention, 105 Shiji Road, Wuyuan, Inner Mongolia 015100, China; (B.K.); (X.W.)
| | - Bin Xu
- Yuexiu District Center for Disease Control and Prevention, 23 Jiaochang West Road, Guangzhou 510030, China; (T.Z.); (B.X.)
| | - Wenhua Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
- Correspondence: ; Tel.: +86-10-6623-7174
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