1
|
Korinek K, Zimmer Z, Teerawichitchainan B, Young Y, Cao Manh L, Toan TK. Cognitive function following early life war-time stress exposure in a cohort of Vietnamese older adults. Soc Sci Med 2024; 349:116800. [PMID: 38640743 PMCID: PMC11105098 DOI: 10.1016/j.socscimed.2024.116800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/22/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024]
Abstract
Although Alzheimer's Disease is a leading cause of death in Vietnam and other post-conflict, low- and middle-income countries, aside from studies of veterans in western populations, research on war-related violence and deprivation as risk factors for cognitive disorders remains sparse. Using data from the Vietnam Health and Aging Study, which relied upon a multistage probability sample of 2447 older adults residing in districts of northern Vietnam differentially exposed to wartime bombing and numerous war-related stressors, this paper investigates associations between early-life war-related stressors and later-life cognitive function in a cohort whose transition to adulthood took place during the American-Vietnam War. Relationships among experiences of severe childhood hunger, war-related violence and environmental hardships, military service, and cognitive function in an analytical sample of 2162 Vietnamese older adults are estimated using quantile regression. Cognitive function is assessed by a modified Mini-Mental State Examination (MMSE) score. Analyses also address posttraumatic stress disorder (PTSD), cardiovascular health, and health behaviors as potential mediators between early life war-related stressors and current cognitive function. Results indicate that experiences of severe hunger in childhood and environmental hardships are associated with poorer cognitive function in older adulthood. PTSD, cardiovascular risk (i.e., hypertension) and disease (i.e., stroke), each of which is heightened by exposure to wartime stressors, are associated with lower cognitive scores. Results suggest that certain war exposures, like involvement in combat duties, are associated with higher cognitive function scores, suggesting that military service either positively selects for cognitive function, or certain forms of service may impart cognitive resilience. Following recent calls to incorporate population-specific stressors to advance explanatory models of cognitive function, these findings suggest that it is critical to assess the enduring scars and resilience of armed conflict in global efforts to understand, prevent, and treat cognitive impairment, Alzheimer's Disease, and related dementias.
Collapse
Affiliation(s)
- Kim Korinek
- Department of Sociology, University of Utah, Salt Lake City, USA.
| | - Zachary Zimmer
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Canada
| | | | - Yvette Young
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Long Cao Manh
- Family Medicine Department, Hanoi Medical University, Hanoi, Viet Nam
| | - Tran Khanh Toan
- Family Medicine Department, Hanoi Medical University, Hanoi, Viet Nam
| |
Collapse
|
2
|
Lin P, Wan B, Zhong J, Wang M, Tang F, Wang L, Guo J, Ye Y, Liu X, Peng L, Deng L. Risk of fall in patients with chronic kidney disease: results from the China health and retirement longitudinal study (CHARLS). BMC Public Health 2024; 24:499. [PMID: 38365639 PMCID: PMC10873935 DOI: 10.1186/s12889-024-17982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD), often coexisting with various systemic disorders, may increase the risk of falls. Our study aimed to assess the prevalence and risk of falls among patients with CKD in China. METHODS We included patients with/without CKD from China Health and Retirement Longitudinal Study (CHARLS). Our primary outcome was the occurrence of fall accidents within the past 2 years. To enhance the robustness of our findings, we employed a multivariable logistic regression model, conducted propensity score analysis, and applied an inverse probability-weighting model. RESULTS A total of 12,658 participants were included, the prevalence of fall accident rates were 17.1% (2,028/11,837) among participants without CKD and 24.7% (203/821) among those with CKD. In the inverse probability-weighting model, participants with CKD exhibited higher fall accident rates (OR = 1.28, 95% CI: 1.08-1.53, p = 0.005 ). Sensitivity and subgroup analysis showed the results still stable. CONCLUSIONS The population in China afflicted with CKD has a significantly heightened risk of experiencing falls, underscoring the crucial importance of intensifying efforts in assessing and preventing fall risks.
Collapse
Affiliation(s)
- Pinli Lin
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Biyu Wan
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Jintao Zhong
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengya Wang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Fang Tang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lingzhen Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Junjun Guo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Yuling Ye
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Xusheng Liu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lu Peng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China.
| | - Lili Deng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China.
| |
Collapse
|
3
|
Zhao H, Fan L, Yi X, Zhu L, Liu X, Hou J, Zhang G, Pan J, Wang C. Effect modification of socioeconomic status on the association of exposure to famine in early life with osteoporosis in women. J Hum Nutr Diet 2023; 36:1349-1358. [PMID: 36919869 DOI: 10.1111/jhn.13164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/02/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND The present study aimed to explore the effect of modification of socioeconomic status (SES) on the association between famine exposure in early life and osteoporosis in adulthood via the baseline data from the Henan Rural cohort study. METHODS A total of 2669 exposed to famine participants were selected from the Henan Rural cohort, and the questionnaires, physical examination and bone mineral density measurement were completed. Specific birth years were used to define five groups: the fetal exposed group, early-childhood exposed group, mid-childhood exposed group, late-childhood exposed group and unexposed group. And the age-matched control group was a combination of the unexposed group and late-childhood exposed group. Multivariable logistic regression models were utilised to analyse the association of famine exposure in early life with osteoporosis in adulthood. RESULTS The prevalence rates of osteoporosis of participants exposed to famine during the fetal period, early-childhood, mid-childhood and the age-matched group were 21.67%, 25.76%, 23.90% and 18.14%, respectively. The adjusted odds ratios (95% confidence interval) of participants suffering from famine during the fetal period, early-childhood and mid-childhood versus age-matched group were 1.19 (0.82-1.73), 1.40 (1.04-1.88) and 1.57 (1.16-2.13), respectively. The female participants yielded consistent results. The risk of osteoporosis was higher in more severe famine eara. Moreover, an attenuated effect of early life famine exposure on osteoporosis was observed in female participants with high SES. CONCLUSIONS Exposure to famine in early life showed a sex-specific association with an increased risk of osteoporosis in adulthood and the severity of famine may exacerbate this association. In addition, the risk could be modified by SES.
Collapse
Affiliation(s)
- Hongfei Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lin Fan
- Orthopedics Department of Wenzhou Central Hospital, Wenzhou, China
| | - Xianhong Yi
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- The Second Clinical Medical School, Wenzhou Medical University, Wenzhou, China
| | - Linghui Zhu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Gongyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jun Pan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- The Second Clinical Medical School, Wenzhou Medical University, Wenzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
4
|
Wiegersma AM, Boots A, Langendam MW, Limpens J, Shenkin SD, Korosi A, Roseboom TJ, de Rooij SR. Do prenatal factors shape the risk for dementia?: A systematic review of the epidemiological evidence for the prenatal origins of dementia. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02471-7. [PMID: 37029828 DOI: 10.1007/s00127-023-02471-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/30/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Prenatal factors such as maternal stress, infection and nutrition affect fetal brain development and may also influence later risk for dementia. The purpose of this systematic review was to provide an overview of all studies which investigated the association between prenatal factors and later risk for dementia. METHODS We systematically searched MEDLINE and Embase for original human studies reporting on associations between prenatal factors and dementia from inception to 23 November 2022. Prenatal factors could be any factor assessed during pregnancy, at birth or postnatally, provided they were indicative of a prenatal exposure. Risk of bias was assessed using the Newcastle Ottawa Scale. We followed PRISMA guidelines for reporting. RESULTS A total of 68 studies met eligibility criteria (including millions of individuals), assessing maternal age (N = 30), paternal age (N = 22), birth order (N = 15), season of birth (N = 16), place of birth (N = 13), prenatal influenza pandemic (N = 1) or Chinese famine exposure (N = 1), birth characteristics (N = 3) and prenatal hormone exposure (N = 4). We observed consistent results for birth in a generally less optimal environment (e.g. high infant mortality area) being associated with higher dementia risk. Lower and higher birth weight and prenatal famine exposure were associated with higher dementia risk. The studies on season of birth, digit ratio, prenatal influenza pandemic exposure, parental age and birth order showed inconsistent results and were hampered by relatively high risk of bias. CONCLUSION Our findings suggest that some prenatal factors, especially those related to a suboptimal prenatal environment, are associated with an increased dementia risk. As these associations may be confounded by factors such as parental socioeconomic status, more research is needed to examine the potential causal role of the prenatal environment in dementia.
Collapse
Affiliation(s)
- Aline Marileen Wiegersma
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
| | - Amber Boots
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Miranda W Langendam
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Medical Library, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Susan D Shenkin
- Geriatric Medicine, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| |
Collapse
|
5
|
Yang M, Yin H, Zhen D, Ding Y, Wang Y, Sun L, He F, Tang X. Exposure to famine in every stage of life and the risk of osteoporosis and fractures later in life: A cross-sectional study. Bone 2023; 168:116644. [PMID: 36566820 DOI: 10.1016/j.bone.2022.116644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/24/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Data on the association between early-life famine exposure and osteoporosis and fractures remain limited and inconclusive. The aim of this study was to investigate the correlation between famine exposure and osteoporosis and fractures. METHODS We performed a cross-sectional analysis using the first follow-up survey data from the China Cardiometabolic Disease and Cancer Cohort Study from 2014 to 2016. We classified 4807 Lanzhou participants into seven groups based on their birthday (non-exposed or exposed in the fetal stage, early childhood, mid-childhood, late childhood, adolescence, or early adulthood). And we combined the non-exposed and early-adulthood exposed groups as a control group, which was called "age balanced group". This age-balanced group was used as the control group to further evaluate the risk of osteoporosis and fracture. We used multiple logistic regression to estimate the association between famine exposure and the risk of osteoporosis (T-score ≤ -1.8 by QUS) and self-reported fracture. RESULTS In women, compared to the age-balanced group, the odds ratios (95 % CI) for the risk of osteoporosis were 1.400(1.034, 1.897), 1.630(1.268, 2.095), 1.707(1.314, 2.218), 2.150(1.732.2.668) and 2.885(2.286,3.641) in the fetal stage, early childhood, mid-childhood, late childhood and adolescence famine-exposed cohorts. In men, no association between famine and osteoporosis was noted with exposed cohort compared with the age-balanced control cohort (p > 0.05). Interestingly, the association between famine exposure and fractures was slightly different from the above results: in women, the odds ratios (95 % CI) for fractures in mid-childhood famine exposure was 1.461(1.082,1.973), in late childhood famine exposure was 1.333(1.035,1.718) and in adolescence famine exposure was 1.607(1.239,2.085). However, compared to the age-balanced control cohort, men exposed to famine in early childhood (OR: 1.801, 95 % CI: 1.010,3.211) had a higher risk of fracture. CONCLUSION Famine exposure in different life stage has adverse effects on bone health. Famine exposure in not only the period from gestation to infancy, but also childhood and adolescence was associated with an increased risk of osteoporosis, especially in women. Exposure to famine in childhood- (mid and late) and adolescence- life period is associated with fracture in women. But, in men early-childhood famine exposure was only associated with fracture.
Collapse
Affiliation(s)
- Mengdi Yang
- First School of Clinical Medicine, Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| | - Hongtao Yin
- Department of Endocrinology, The First Hospital of Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| | - Donghu Zhen
- Department of Endocrinology, The First Hospital of Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China.
| | - Yulu Ding
- First School of Clinical Medicine, Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| | - Yujie Wang
- First School of Clinical Medicine, Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| | - Linnan Sun
- First School of Clinical Medicine, Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| | - Fengying He
- First School of Clinical Medicine, Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Donggang West Road, Lanzhou 730000, Gansu, People's Republic of China
| |
Collapse
|
6
|
Wiegersma AM, Boots A, Roseboom TJ, de Rooij SR. Exposure to the Dutch Famine in Early Gestation and Cognitive Function and Decline in Older Age. Nutrients 2023; 15:nu15020293. [PMID: 36678168 PMCID: PMC9867093 DOI: 10.3390/nu15020293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/30/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
People exposed to the 1944-1945 Dutch famine in early gestation performed worse on a selective attention task at age 58 and reported more cognitive problems at age 72. We here hypothesized that undernutrition in early gestation is associated with poorer cognitive functioning in older age and a higher rate of cognitive decline. We tested this hypothesis in the Dutch famine birth cohort in men and women combined and separately. We assessed cognitive function using a Stroop-like, trail-making and 15-word task (at ages 68 and 74) and the Montreal cognitive assessment as well as self-perceived cognitive problems (at age 74) in 73 men (n = 34) and women (n = 39). We compared cognitive function and decline (change in cognitive function between age 68 and 74) between those exposed in early gestation and those not exposed (born before or conceived after the famine). Although in both men and women cognitive function declined from age 68 to 74, cognitive task scores and the rate of decline did not differ between those exposed or unexposed to famine. At age 74, men exposed to famine in early gestation more often reported cognitive problems, although this was not statistically different from unexposed men (OR 3.1 [95%CI 0.7 to 13.0]). We did not find evidence of increased cognitive decline after prenatal undernutrition. Selective participation and mortality may have hampered our ability to detect potential true effects. The self-perceived cognitive problems among men who had been exposed to famine in early gestation might be an indication of future dementia risk.
Collapse
Affiliation(s)
- Aline Marileen Wiegersma
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
- Correspondence:
| | - Amber Boots
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
| | - Tessa J. Roseboom
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Susanne R. de Rooij
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|
7
|
Zhang H, Ho WC. The Long-Term Effect of Famine Exposure on Cognitive Performance: Evidence from the 1959-1961 Chinese Famine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16882. [PMID: 36554762 PMCID: PMC9779583 DOI: 10.3390/ijerph192416882] [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: 10/29/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
We examined the long-term impact of the 1959-1961 Chinese Famine on the survivors' cognitive performance in this study. Using data from the 2010 China Family Panel Study, our cohort comparison analysis showed that people who experienced the famine in early childhood (aged 1-3) had a lower score on a vocabulary test and that those who were exposed to the famine in utero did not differ from those born after the famine, probably due to positive selection for the in utero survivors. To deal with the problem of the lack of a comparable control group, we further applied a migrant-stayer comparison approach, with data from the 2016 China Family Panel Study and the 2017 Hong Kong Panel Study of Social Dynamics, to examine the effects of famine exposure at different life stages on adult cognition. We compared the people who stayed in Guangdong with the people who crossed the border to Hong Kong before the famine. The results showed that Guangdong stayers who experienced the famine when they were aged 1-18 had worse performance in immediate word recall. The findings suggested that exposure to malnutrition during childhood has long-term adverse effects on cognitive performance.
Collapse
Affiliation(s)
- Han Zhang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Wing Chung Ho
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
8
|
Ramirez D, Haas SA. Windows of Vulnerability: Consequences of Exposure Timing during the Dutch Hunger Winter. POPULATION AND DEVELOPMENT REVIEW 2022; 48:959-989. [PMID: 37063488 PMCID: PMC10087479 DOI: 10.1111/padr.12513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Prior research on early-life exposures to famine has established in utero development as a critical period of vulnerability to malnutrition. Yet, previous research tends to focus narrowly on this stage, at the expense of a more comprehensive examination of childhood. As a result, the literature has yet to compare the severity of the consequences of exposure to malnutrition across developmentally salient periods. Such comparison is crucial not only in the magnitude of effects but also in the nature of outcomes. Using a restricted population registry-linked health survey, this study examines the Dutch Hunger Winter to provide a comprehensive examination of the long-term consequences of in utero, infant, childhood, and adolescent exposure to famine. The results show malnutrition leads to heterogeneous effects depending on when the exposure occurs. In utero exposure to malnutrition leads to deleterious conditions in physical health and lower socioeconomic attainment. For older cohorts, results suggest a resilience to the effects of malnutrition on physical health in late life, but a higher vulnerability to socioeconomic stunting. Furthermore, the results suggest important gender differences in the long-term impact of malnutrition. Males consistently show stronger negative consequences across a wider array of conditions.
Collapse
|
9
|
Wang K, Xu L, Liu L, Zhan S, Wang S, Song Y. Sex differences in the association between the change in triglyceride‑glucose index and cognitive decline: A population-based cohort study. J Affect Disord 2022; 316:42-49. [PMID: 35952934 DOI: 10.1016/j.jad.2022.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/14/2022] [Accepted: 08/06/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies indicated that insulin resistance (IR) was related to cognitive decline. This study aimed to investigate whether triglyceride-glucose (TyG) as a surrogate marker of IR can detect the association between IR and cognitive decline, and explore sex-specific association between the longitudinal change in TyG index and cognitive decline in the middle-aged and elderly population in China. METHODS Data from the China Health and Retirement Longitudinal Study, which include 2358 females and 2062 males, were used. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting blood glucose [mg/dL] / 2). Cognitive score was measured by word recall test and mental status test. Logistic regression was used to assess the association between change in TyG index and cognitive decline in men and women from 2011 to 2015, respectively. Subgroup analysis by age was also performed. RESULTS The fourth quartile of change in TyG index was significantly associated with the increased risk of decline in global cognition compared with the first quartile in men [odds ratio (OR) 1.32, 95 % CI 1.03 to 1.71]. Stratified by age groups, the significant association between TyG index and cognitive decline was only found in men aged under 60 years old (OR 1.51, 95 % CI 1.07 to 2.13). LIMITATIONS We only observed the association between TyG index and cognitive decline, but not the severity of the decline. CONCLUSIONS The increased TyG index is related to the risk of cognitive decline in men. This study provided new evidence for formulating sex-specific prevention and treatment strategies for cognitive decline.
Collapse
Affiliation(s)
- Kai Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, China; Shandong Institute of Endocrine & Metabolic Diseases, Jinan, China
| | - Lu Xu
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Lili Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Siyan Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, China; Shandong Institute of Endocrine & Metabolic Diseases, Jinan, China.
| |
Collapse
|
10
|
de Rooij SR. Are Brain and Cognitive Reserve Shaped by Early Life Circumstances? Front Neurosci 2022; 16:825811. [PMID: 35784851 PMCID: PMC9243389 DOI: 10.3389/fnins.2022.825811] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/13/2022] [Indexed: 01/22/2023] Open
Abstract
When growing older, many people are faced with cognitive deterioration, which may even amount to a form of dementia at some point in time. Although neuropathological signs of dementia disorders can often be demonstrated in brains of patients, the degree to which clinical symptoms are present does mostly not accurately reflect the amount of neuropathology that is present. Sometimes existent pathology even goes without any obvious clinical presentation. An explanation for this phenomenon may be found in the concept of reserve capacity. Reserve capacity refers to the ability of the brain to effectively buffer changes that are associated with normal aging processes and to cope with pathological damage. A larger reserve capacity has been suggested to increase resilience against age-associated cognitive deterioration and dementia disorders. Traditionally, a division has been made between brain reserve, which is based on morphological characteristics of the brain, and cognitive reserve, which is based on functional characteristics of the brain. The present review discusses the premises that brain and cognitive reserve capacity are shaped by prenatal and early postnatal factors. Evidence is accumulating that circumstances during the first 1,000 days of life are of the utmost importance for the lifelong health of an individual. Cognitive deterioration and dementia disorders may also have their origin in early life and a potentially important pathway by which the early environment affects the risk for neurodegenerative diseases is by developmental programming of the reserve capacity of the brain. The basic idea behind developmental programming of brain and cognitive reserve is explained and an overview of studies that support this idea is presented. The review is concluded by a discussion of potential mechanisms, synthesis of the evidence and relevance and future directions in the field of developmental origins of reserve capacity.
Collapse
Affiliation(s)
- Susanne R. de Rooij
- Epidemiology and Data Science, University of Amsterdam, Amsterdam, Netherlands
- Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Amsterdam Reproduction and Development, Amsterdam, Netherlands
| |
Collapse
|
11
|
Zhou R, Li J, Chen M. The Association Between Cognitive Impairment and Subsequent Falls Among Older Adults: Evidence From the China Health and Retirement Longitudinal Study. Front Public Health 2022; 10:900315. [PMID: 35784248 PMCID: PMC9240660 DOI: 10.3389/fpubh.2022.900315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Previous studies have suggested that cognitive impairment is associated with falls in older adults. However, the consistency of results among different subgroups defined by multiple characteristics of the elderly has not yet been tested. Additionally, results are inconsistent regarding the effects of different cognitive domains on falls. Therefore, this study sought to use representative data from a nationwide study to better understand the longitudinal association between cognitive impairment and subsequent falls in older adults. Methods The current study was conducted based on the China Health and Retirement Longitudinal Study (CHARLS) data of respondents aged ≥60 years in 2015 and the fall data in 2018. The respondents were divided into subgroups according to different demographic characteristics. Multiple logistic regression analysis was conducted to adjust for various confounding factors and evaluate the association between cognitive impairment and falls. Results Of the 5,110 respondents included in this study, 1,093 (21.39%) had falls within the last 2 years. A significant association was found between cognitive impairment and subsequent falls (OR = 0.97, 95% CI 0.95–0.99, P = 0.001) after adjusting for all of the covariates related to falls. Analysis of different cognitive domains showed that orientation (OR = 0.94, 95% CI 0.90–0.99, P = 0.013) and memory (OR = 0.93, 95% CI 0.90–0.97, P = 0.001) were significantly associated with falls. In subgroup analysis, the ORs of people aged 60–74 years, male, with lower education level were 0.97 (95% CI 0.95–0.99, P = 0.008), 0.96 (95% CI 0.93–0.98, P = 0.001), and 0.97 (95% CI 0.95–0.99, P = 0.001), respectively, suggesting that the associations were also statistically significant in these subgroups. There was also a significant association both in urban (OR = 0.97, 95% CI 0.95–0.99, P = 0.001) and in rural residents (OR = 0.97, 95% CI 0.95–0.99, P = 0.003). Conclusions Our results suggest that the associations between cognition and falls vary depending on the different demographic characteristics of older adults. These findings may be useful for designing more accurate identification and intervention for the fall risk for specific high-risk groups.
Collapse
Affiliation(s)
- Rong Zhou
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiayu Li
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Meiling Chen
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
- *Correspondence: Meiling Chen
| |
Collapse
|
12
|
Li N, Wang Y, Deng Q, Hu J, Zhou J. A Multilevel Physical Activity Intervention Among Chinese Rural Older Adults (Stay Active While Aging): A Study Protocol for a Clustered Randomized Controlled Trial. Front Public Health 2022; 10:760457. [PMID: 35592074 PMCID: PMC9110770 DOI: 10.3389/fpubh.2022.760457] [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: 08/18/2021] [Accepted: 04/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although a large number of studies have confirmed the benefits of physical activity (PA) in preventing age-related diseases and disabilities, a growing number of older people spent more time in sedentary behavior as opposed to PA. To reverse the alarming trend, numerous studies have corroborated the effectiveness of PA interventions in improving PA among older adults. However, such research is scarce in rural China, where a majority of older adults do not meet the PA recommendation. The Stay Active While Aging (SAWA) aimed to conduct an intervention to improve the PA level among older adults in rural China. Methods The SAWA is designed as a single-blind, clustered randomized controlled trial carried out in rural Sichuan, China with an 8-week intervention and a 24-month follow-up. The intervention group will receive a multilevel intervention (individual, interpersonal, and community levels), while the control group will not. The primary outcome is the PA level. Secondary outcome measures include sedentary behavior level, self-efficacy, self-regulation, cognitive function, night-time sleep quality, and anthropometry. The difference-in-differences (DID) will be performed to investigate the between-group differences, adjusted for baseline data and covariates. Discussion The SAWA trial will provide a multilevel intervention based on the socio-ecologic model among older adults in rural China. We target the PA level and health status changes while also focus on the maintenance of such intervention during 24 months. If the SAWA produces positive results, it will be possible to recommend similar strategies to be implemented in other Chinese older adults and beyond. Trial registration ChiCTR2100045653 (https://www.chictr.org.cn/index.aspx).
Collapse
Affiliation(s)
- Nanyan Li
- Department of Health Behavior and Social Medicine, West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yufei Wang
- Department of Health Behavior and Social Medicine, West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qian Deng
- Department of Health Behavior and Social Medicine, West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Julinling Hu
- Department of Health Behavior and Social Medicine, West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Junmin Zhou
- Department of Health Behavior and Social Medicine, West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
13
|
Grigoletti-Lima GB, Lopes MG, Franco ATB, Damico AM, Boer PA, Rocha Gontijo JA. Severe Gestational Low-Protein Intake Impacts Hippocampal Cellularity, Tau, and Amyloid-β Levels, and Memory Performance in Male Adult Offspring: An Alzheimer-Simile Disease Model? J Alzheimers Dis Rep 2022; 6:17-30. [PMID: 35243209 PMCID: PMC8842744 DOI: 10.3233/adr-210297] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 11/25/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Maternal undernutrition has been associated with psychiatric and neurological disorders characterized by learning and memory impairment. Objective: Considering the lack of evidence, we aimed to analyze the effects of gestational protein restriction on learning and memory function associated with hippocampal cell numbers and neurodegenerative protein content later in life. Methods: Experiments were conducted in gestational low- (LP, 6% casein) or regular-protein (NP, 17% casein) diet intake offspring. Behavioral tests, isolated hippocampal isotropic fractionator cell studies, immunoblotting, and survival lifetime were observed. Results: The birthweight of LP males is significantly reduced relative to NP male progeny, and hippocampal mass increased in 88-week-old LP compared to age-matched NP offspring. The results showed an increased proximity measure in 87-week-old LP compared to NP offspring. Also, LP rats exhibited anxiety-like behaviors compared to NP rats at 48 and 86-wk of life. The estimated neuron number was unaltered in LP rats; however, non-neuron cell numbers increased compared to NP progeny. Here, we showed unprecedented hippocampal deposition of brain-derived neurotrophic factor, amyloid-β peptide (Aβ), and tau protein in 88-week-old LP relative to age-matched NP offspring. Conclusion: To date, no predicted studies showed changes in hippocampal morphological structure in maternal protein-restricted elderly offspring. The current data suggest that gestational protein restriction may accelerate hippocampal function loss, impacting learning/memory performance, and supposedly developing diseases similar to Alzheimer’s disease (AD) in elderly offspring. Thus, we propose that maternal protein restriction could be an elegant and novel method for constructing an AD-like model in adult male offspring.
Collapse
Affiliation(s)
- Gabriel Boer Grigoletti-Lima
- Fetal Programming and Hydroelectrolyte MetabolismLaboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at StateUniversity of Campinas, Campinas, SP, Brazil
| | - Marcelo Gustavo Lopes
- Fetal Programming and Hydroelectrolyte MetabolismLaboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at StateUniversity of Campinas, Campinas, SP, Brazil
| | - Ana Tereza Barufi Franco
- Fetal Programming and Hydroelectrolyte MetabolismLaboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at StateUniversity of Campinas, Campinas, SP, Brazil
| | - Aparecida Marcela Damico
- Fetal Programming and Hydroelectrolyte MetabolismLaboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at StateUniversity of Campinas, Campinas, SP, Brazil
| | - Patrìcia Aline Boer
- Fetal Programming and Hydroelectrolyte MetabolismLaboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at StateUniversity of Campinas, Campinas, SP, Brazil
| | - José Antonio Rocha Gontijo
- Fetal Programming and Hydroelectrolyte MetabolismLaboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at StateUniversity of Campinas, Campinas, SP, Brazil
| |
Collapse
|
14
|
Liu Y, Liu Y, Lu Y, Li J, He S. Association of Parental Famine Exposure With Offspring Depression and Cognition Function. Front Psychiatry 2022; 13:812805. [PMID: 35449569 PMCID: PMC9016118 DOI: 10.3389/fpsyt.2022.812805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The effect of early exposure to famine on depression and cognition in adulthood has been shown, but the intergenerational association of famine remain to be explored. This study focused on exploring the association of parental famine exposure with depression and cognition in the offspring. METHODS Based on the Chinese Family Panel Studies database, which is a longitudinal survey, we included 5,150 individuals born between 1959 and 1961 and divided them into fetal-exposed, infancy-exposed (birth year = 1957-1958), school-age-exposed (birth year = 1949-1956), adolescent-exposed (birth year = 1946-1948), and unexposed groups. We used one-way analysis of variance, multiple linear regression, and one follow-up measurement to analyze the association between parental famine exposure and offspring depression and cognitive function. RESULTS Compared with the unexposed group, the correlations between parental famine exposure during fetal period and their cognitive function (mother: β = -1.614, 95% CI: -2.535, -0.693; p = 0.001; father: β = -2.153, 95% CI: -3.104, -1.202, p < 0.001) were significant. For the offspring, there was a negative correlation between famine exposure of fathers during the fetal period and depression in their offspring (β = -0.477, 95% CI: -0.907, -0.047; p = 0.030). There was a negative correlation between maternal famine exposure during the infant and adolescent period and cognitive function in the offspring (math test: β = -0.730, 95% CI: -1.307, -0.153; p = 0.013; word test: β = -2.346, 95% CI: -4.067, -0.625; p = 0.008). LIMITATIONS Not all variables related to depression and cognition function were included in the CFPS database, and the other unknown or unmeasured confounders may explain our results.
Collapse
Affiliation(s)
- Ye Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Yu Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Yuzhu Lu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Shulan He
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| |
Collapse
|
15
|
Yang YY, Zhang D, Ma LY, Hou YF, Bi YF, Xu Y, Xu M, Zhao HY, Sun LH, Tao B, Liu JM. Association of famine exposure and the serum calcium level in healthy Chinese adults. Front Endocrinol (Lausanne) 2022; 13:937380. [PMID: 36017320 PMCID: PMC9395633 DOI: 10.3389/fendo.2022.937380] [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: 05/06/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Famine exposure and higher serum calcium levels are related with increased risk of many disorders, including Alzheimer's disease, atherosclerosis, diabetes, and osteoporosis. Whether famine exposure has any effect on serum calcium level is unclear. Besides, the normal reference range of serum calcium is variable among different populations. Our aims are 1) determining the reference interval of calcium in Chinese adults; 2) exploring its relationship with famine exposure. METHODS Data in this study was from a cross-sectional study of the epidemiologic investigation carried out during March-August 2010 in Jiading district, Shanghai, China. Nine thousand and two hundred eleven participants with estimated glomerular filtration rate (eGFR) ≥60ml/min/1.73m2 were involved to calculate reference interval of total calcium from 10569 participants aged 40 years or older. The analysis of famine exposure was conducted in 9315 participants with complete serum biochemical data and birth year information. RESULTS After rejecting outliers, the 95% reference interval of total serum calcium was 2.122~2.518 mmol/L. The equation of albumin-adjusted calcium was: Total calcium + 0.019* (49-Albumin), with a 95% reference interval of 2.151~2.500 mmol/L. Compared to the age-balanced control group, there was an increased risk of being at the upper quartile of total serum calcium (OR=1.350, 95%CI=1.199-1.521) and albumin-adjusted calcium (OR=1.381, 95%CI=1.234-1.544) in subjects experienced famine exposure in childhood. Females were more vulnerable to this impact (OR= 1.621, 95%CI= 1.396-1.883 for total serum calcium; OR=1.722, 95%CI= 1.497-1.980 for albumin-adjusted calcium). CONCLUSIONS Famine exposure is an important environmental factor associated with the changes in circulating calcium concentrations, the newly established serum calcium normal range and albumin-adjusted calcium equation, together with the history of childhood famine exposure, might be useful in identifying subjects with abnormal calcium homeostasis and related diseases, especially in females.
Collapse
Affiliation(s)
- Yu-ying Yang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Deng Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling-ying Ma
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan-fang Hou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-fang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong-yan Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-hao Sun
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Li-hao Sun, ; Bei Tao, ; Jian-min Liu,
| | - Bei Tao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Li-hao Sun, ; Bei Tao, ; Jian-min Liu,
| | - Jian-min Liu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Li-hao Sun, ; Bei Tao, ; Jian-min Liu,
| |
Collapse
|
16
|
Zhang K, Zhang W. Adverse Childhood Experiences and Mild Cognitive Impairment in Later Life: Exploring Rural/Urban and Gender Differences Using CHARLS. J Appl Gerontol 2021; 41:1454-1464. [PMID: 34933578 DOI: 10.1177/07334648211064796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This paper aims to examine whether and how adverse childhood experiences are associated with mild cognitive impairment among middle-aged and older adults in China, and if the associations vary by gender and rural/urban residence. Using four waves of data from the China Health and Retirement Longitudinal Study, cox proportional hazard models were applied. Results showed that the rural and female subsamples were significantly disadvantaged and were more likely to be cognitively impaired. Moreover, childhood family socioeconomic status and childhood social relationships were significantly associated with the risk of mild cognitive impairment for the study sample. Our findings suggest that, for middle-aged and older Chinese adults, adverse childhood experiences could have long-lasting impacts on cognitive functioning throughout the life course.
Collapse
Affiliation(s)
- Keqing Zhang
- Department of Sociology, 204835University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Wei Zhang
- Department of Sociology, 204835University of Hawai'i at Mānoa, Honolulu, HI, USA
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Yang R, Xu D, Wang H, Xu J. Longitudinal trajectories of physical functioning among Chinese older adults: the role of depressive symptoms, cognitive functioning and subjective memory. Age Ageing 2021; 50:1682-1691. [PMID: 34228776 DOI: 10.1093/ageing/afab135] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Maintaining physical functioning (i.e. mobility, activities of daily living [ADLs], instrumental activities of daily living [IADLs]) in older adults is essential for independent living. However, little is known about how longitudinal trajectories of physical functioning differ by varying levels of depressive symptoms, subjective memory impairment and cognitive functioning. We aimed to examine whether, and to what degree, the rate of change in physical functioning over time was associated with depressive symptoms, subjective memory and cognitive functioning. DESIGN A correlational longitudinal design. METHODS The sample included 5,519 older adults (mean age = 68.13 years) from the China Health and Retirement Longitudinal Study (three waves: 2011-15) who self-reported their depressive symptoms, subjective memory impairment and physical functioning. Cognitive functioning was assessed through interview-based tests. RESULTS There were significant increases in mobility impairment (β = 0.27, P < 0.001), ADLs impairment (β = 0.05, P < 0.001) and IADLs impairment (β = 0.03, P = 0.006) over time. Compared with the mean score at baseline in 2011, the mobility, ADLs and IADLs impairment increased by 13.32, 10.57 and 4.34% for every 2 years, respectively. Those with high depressive symptoms had accelerated rates of mobility (β = 0.212, P < 0.001), ADLs (β = 0.104, P < 0.001) and IADLs impairment (β = 0.076, P = 0.002). Those with poorer cognitive functioning had more rapid rates of mobility impairment. In contrast, those with differing levels of subjective memory impairment did not experience different physical functioning trajectories. CONCLUSIONS High depressive symptoms and poor cognitive functioning may be precursors to rapid declines in physical functioning. Proactive screening for these precursors may attenuate physical decline among Chinese older adults.
Collapse
Affiliation(s)
- Rumei Yang
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China
| | - Dongjuan Xu
- Purdue University School of Nursing, West Lafayette, IN 47907-2069, USA
| | - Haocen Wang
- Department of Health and Kinesiology, Texas A&M University, College station, TX 77845, USA
| | - Jiayun Xu
- Purdue University School of Nursing, West Lafayette, IN 47907-2069, USA
| |
Collapse
|
19
|
Arage G, Belachew T, Abera M, Abdulhay F, Abdulahi M, Hassen Abate K. Consequences of early life exposure to the 1983-1985 Ethiopian Great Famine on cognitive function in adults: a historical cohort study. BMJ Open 2020; 10:e038977. [PMID: 32973064 PMCID: PMC7517579 DOI: 10.1136/bmjopen-2020-038977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate the association between early life famine exposure and cognitive function in adults. DESIGN Historical cohort study SETTING: North Wollo Zone, Northeast Ethiopia. PARTICIPANTS We recruited 1047 adult men and women aged 30-38 years who had history of early life exposure to Ethiopian great famine. Based on self-reported age and birth date, participants were categorised into famine exposed in early life (prenatal/postnatal) and non-exposed groups. OUTCOME MEASURES The primary outcome measure of this study was cognitive function in adults after early life exposure to famine. Cognitive function was measured using Montreal Cognitive Assessment-basic. Associations between exposure and outcome variables were examined by linear regression analysis models. RESULTS Adjusted for covariates, early life exposure to famine showed 1.29 (β=-1.29; 95% CI -2.16 to -0.52) points lower cognitive function score compared with non-exposed. Based on subanalysis for timing of famine exposure, postnatal exposure to famine resulted in 2.26 (β=-2.26; 95% CI -3.12 to -1.36) points lower cognitive function score compared with non-exposed groups. Prenatal famine exposure had 1.26 (β=-1.26; 95% CI -2.35 to 0.94) points lower cognitive function score although not statistically significant. CONCLUSIONS Famine exposure in early life was associated with cognitive functions in adults. While the overall findings highlight the importance of optimal nutrition in early life for brain growth and development, the association observed between postnatal famine exposure and adult cognitive function may indicate the relative importance of learning and experience during early childhood for optimal brain development after birth. Further studies are needed to elucidate the potential mechanism behind this association.
Collapse
Affiliation(s)
- Getachew Arage
- Nutrition and Dietetics, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tefera Belachew
- Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Mubarek Abera
- Psychiatry, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Fedilu Abdulhay
- Obstetrics and Gynecology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Misra Abdulahi
- Department of Population and Family Heath, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Kalkidan Hassen Abate
- Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| |
Collapse
|
20
|
The relationship between famine exposure during early life and carotid plaque in adulthood. Eur J Clin Nutr 2020; 75:546-554. [PMID: 32939040 DOI: 10.1038/s41430-020-00756-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/24/2020] [Accepted: 09/05/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Famine exposure is a potential risk factor for adverse cardiometabolic health. However, the relationship between famine exposure during early life and carotid plaque in adulthood remains unclear. Therefore, the aim was to investigate the relationship between famine exposure during early life and the risks for carotid plaque in adulthood. METHODS This was a cross-sectional study. Data were collected between 2017 and 2018 in Guangdong, China. Subjects who were born between 1 October 1952 and 30 September 1964, and had the carotid ultrasound measurement were enrolled. All included participants were divided into five groups: no exposure, fetal exposure, early-childhood exposure, mid-childhood exposure, and late-childhood exposure. Carotid plaque was assessed by carotid ultrasound examination. Multivariate logistic regression was used to estimate the odds ratio (OR) and confidence interval (CI) between famine exposure and carotid plaque. RESULTS There were 2652 subjects enrolled, 973 (36.7%) of them were males, and the mean age was 59.1 ± 3.6 years. The prevalence of carotid plaque in unexposed, fetal-exposed, early-childhood, mid-childhood, and late-childhood exposed groups were 40.2%, 40.8%, 55.3%, 56.8%, and 62.1%, respectively. When compared with the unexposed group, the fully adjusted ORs for carotid plaque from fetal-exposed, early-childhood, mid-childhood to late-childhood exposed were 1.023 (95% CI: 0.771, 1.357, P = 0.872), 1.755 (95% CI: 1.356, 2.275, P < 0.001), 1.780 (95% CI: 1.391, 2.280, P < 0.001), and 2.119 (95% CI: 1.643, 2.739, P < 0.001), respectively. Subgroup analyses showed that the famine effect on carotid plaque did not interact with body mass index, gender, smoking status, hypertension, and diabetes history (all P for interaction > 0.500). CONCLUSIONS Famine exposure during early life was significantly associated with an increased risk of carotid plaque in adulthood.
Collapse
|
21
|
Rong H, Lai X, Mahmoudi E, Fang H. Exposure to Chinese famine in early life and the risk of sensory impairment in adulthood. J Epidemiol Community Health 2020; 75:16-21. [PMID: 32859671 DOI: 10.1136/jech-2020-213775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/28/2020] [Accepted: 07/31/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Studies have shown that malnutrition in early life has a negative effect on midlife cognitive functions. Little is known, however, about the relationship between early-life malnutrition and visual, hearing or dual sensory impairments in adulthood. This study aims to investigate the association between exposure to the 1959-1961 Chinese famine in early life and sensory impairments in adulthood. METHODS A total of 6347 adults born between 1952 and 1964 surveyed in the 2015 China Health and Retirement Longitudinal Study were included in this study. The presence of sensory impairments was identified by self-reported assessment of visual and hearing functions. The associations between multi-stage early-life famine exposure and sensory functions were estimated using the multiple generalised linear model. RESULTS Compared with the unexposed group, respondents exposed to famine in the fetal period and late childhood had a significantly higher risk of hearing impairment (OR 1.54, 95% CI 1.06 to 2.24; OR 1.75, 95% CI 1.23 to 2.50) and dual sensory impairments (OR 1.45, 95% CI 1.00 to 2.11; OR 1.55, 95% CI 1.09 to 2.21), respectively. Furthermore, in severely famine-affected areas, the early, mid and late childhood-exposed groups were more likely to have hearing and dual sensory impairments than the unexposed group. Those associations were not observed in less famine-affected areas. However, no significant association was found between famine exposure and visual impairment in early-life famine-exposed group. CONCLUSION Exposure to Chinese famine in the fetal period and late childhood was linked to hearing and dual sensory impairments in adulthood.
Collapse
Affiliation(s)
- Hongguo Rong
- China Center for Health Development Studies, Peking University, Beijing, China.,Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaozhen Lai
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Elham Mahmoudi
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China .,Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing, China.,Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| |
Collapse
|
22
|
Huang YQ, Liu L, Yu YL, Lo K, Chen CL, Huang JY, Zhou YL, Feng YQ. The relationship between famine exposure in early life and left atrial enlargement in adulthood. J Hum Nutr Diet 2020; 34:356-364. [PMID: 32830406 DOI: 10.1111/jhn.12802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Increased left atrium diameter (LAD) is associated with an elevated risk of cardiovascular diseases. The relationship between nutrition status and left atrial enlargement (LAE) is still unclear. The present study aimed to investigate the association of famine exposure in early life with LAE in adulthood. METHODS Participants were divided into non-exposed, fetal, early, middle and late childhood exposed groups according to birth data. LAE was defined when LAD was ≥3.9 cm in women and ≥4.1 cm in men, or ≥2.3 cm m-2 by a sex-independent cut-off normalised for body surface area. Multivariate logistic regression was performed to calculate the odds ratio (OR) and confidence interval (CI) between famine exposure and LAE. RESULTS In total, 2522 [905 male, mean (SD) age 59.1 (3.65) years] subjects were enrolled, including 392 (15.5%) LAE subjects. The prevalence of LAE in non-exposed, fetal, early, middle and late childhood exposed groups was 55 (10.8%), 38 (11.2%), 88 (18.1%), 102 (16.7%) and 109 (19.0%), respectively. Compared to the non-exposed group, the ORs for LAE were in fetal (OR = 0.956, 95% CI = 0.605-1.500, P = 0.847), late (OR = 1.748, 95% CI = 1.208-2.555, P = 0.003), middle (OR = 1.647, 95% CI = 1.140-2.403, P = 0.008) and early (OR = 1.630, 95% CI = 1.116-2.399, P = 0.012) childhood exposed groups after adjusting potential cofounders. When stratified by gender, smoking, body mass index, hypertension and diabetes, we found that the effect of famine exposure on LAE was only modified by diabetes (Pinteraction = 0.007). CONCLUSIONS Famine exposure during childhood stage might increase the risk of LAE in adults, and this effect interacts with diabetes.
Collapse
Affiliation(s)
- Y-Q Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - L Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Y-L Yu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - K Lo
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China.,Department of Epidemiology, Centre for Global Cardio-metabolic Health, Brown University, Providence, USA
| | - C-L Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - J-Y Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Y-L Zhou
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Y-Q Feng
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| |
Collapse
|