Early-Life Exposure to the Chinese Famine and Risk of Hyperuricemia in Adult Females in Qingdao

Abstract Purpose: We aimed to explore whether exposure to the Chinese famine in early life was associated with hyperuricemia in adulthood. Methods and Results: Two population-based cross-sectional surveys involving randomly selected Chinese adults aged 35–74 years were conducted in Qingdao, China in 2006 and 2009. 9055 subjects from the two surveys were grouped into four birth groups of fetal/infant exposed(born between 1959/1/1 and 1962/12/31), childhood exposed(born between 1950/1/1 and 1958/12/31), adolescence exposed(born between 1942/1/1 and 1949/12/31) and the unexposed(born before 1941 and after 1963). Multivariate logistic regression models were used to calculate the odd ratios (ORs) and 95% confidence intervals (CIs) of hyperuricemia in different exposed groups. Overall, famine exposure in the fetal/infant period, childhood and adolescence was not associated with adulthood hyperuricemia (all P>0.05). In females, childhood exposed group(OR=1.59, 95%CI:1.25-2.02) and adolescence exposed group(OR=1.74, 95%CI:1.30-2.33) both had higher risks to have hyperuricemia in adult. However, this difference was not found in fetal/infant exposed group. In males, no significant relation was observed in any famine exposed group (all P>0.05). Conclusions: Exposure to famine in childhood and adolescence is associated with an increased risk of hyperuricemia for adulthood of females, but not in males. Adequate nutrition during early life appears to be beneficial to prevent hyperuricemia of adult females.

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Association between early-life exposure to the Great Chinese Famine and poor physical function later in life: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027450 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027450

Author(s):

Tao Tao ◽

Lingyan Dai ◽

JinXiang Ma ◽

Yusi Li ◽

Zhuoyuan Guo

Keyword(s):

Physical Function ◽

Early Life ◽

Later Life ◽

Exposed Group ◽

Self Report ◽

Postnatal Exposure ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Fetal Period ◽

Early Life Exposure

ObjectivesThis study aimed to evaluate the association between early-life exposure to the Great Chinese Famine (1959–1961) and the prevalence of poor physical function in midlife.DesignA population-based historical prospective study was performed as part of a wider cross-sectional survey. Exposure to famine was defined by birthdate, and participants were divided into non-exposed group, fetal-exposed group and infant-exposed group.Setting and participantsA total of 3595 subjects were enrolled into the study from the China Health and Retirement Longitudinal Study (CHARLS) 2015 based on random selection of households that had at least one member aged 45 years old and older in 28 provinces of mainland China.Main outcome measuresPhysical function status was assessed by a six-item self-report on the Barthel scale which rated basic activities of daily living (BADL).Results743 (20.7%) out of all participants were exposed to the Great Chinese Famine in their fetal periods, while 1550 (43.1%) participants were exposed at the age of an infant. The prevalence of poor physical function in the non-exposed group, fetal period-exposed group and infant period-exposed group were 12.3%, 15.5% and 17.0%, respectively. Among males, after stratification by gender and severity of famine, the prevalence of poor physical function in the fetal period was significantly higher (OR 2.40, 95% CI 1.18 to 4.89, p=0.015) than the non-exposed group in severely affected areas, even after adjusting for the number of chronic diseases, place of residence, smoking and alcohol drinking habits, marital status, educational level and body mass index. A similar connection between prenatal and early postnatal exposure to the Great Chinese Famine and the prevalence of poor physical function in midlife, however, was not observed from female adults.ConclusionsMales who were exposed to the Great Chinese Famine (1959–1961) present considerably decreased physical function in their later life.

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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 ◽

10.1155/2021/5594718 ◽

2021 ◽

Vol 2021 ◽

pp. 1-17

Author(s):

Lin Zhang ◽

Liu Yang ◽

Congzhi Wang ◽

Ting Yuan ◽

Dongmei Zhang ◽

...

Keyword(s):

Total Population ◽

Population Based ◽

Cross Sectional Study ◽

Exposed Group ◽

Middle Aged ◽

Cross Sectional ◽

Famine Exposure ◽

Males And Females ◽

Baseline Characteristics ◽

Older Chinese

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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Association of hypertriglyceridemic waist phenotype with renal function impairment: a cross-sectional study in a population of Chinese adults

10.21203/rs.3.rs-22590/v1 ◽

2020 ◽

Author(s):

Yun Qiu ◽

Qi Zhao ◽

Yian Gu ◽

Na Wang ◽

Yuting Yu ◽

...

Keyword(s):

Renal Function ◽

Risk Factor ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Chinese Adults ◽

Cross Sectional ◽

Logistic Regression Models ◽

Hypertriglyceridemic Waist ◽

Increased Risk

Abstract Background: The hypertriglyceridemic waist (HTGW) phenotype has been suggested as a risk factor for chronic kidney disease (CKD), but evidence on relationship of triglyceride waist phenotypes with estimated glomerular filtration rate (eGFR) status and severity is limited. Our aim was to explore the association of triglyceride waist phenotypes with reduced eGFR and various decreased eGFR stages among Chinese adults.Methods: A population-based, cross-sectional study was conducted among Chinese participants aged 20-74 years during June 2016 to December 2017 in Shanghai, China. An eGFR value below 60 mL/min/1.73 m2 was defined as Decreased eGFR. The HTGW phenotype was defined as a triglycerides (TG) level ≥1.7 mmol/L and a waist circumference (WC) ≥90 cm for men and ≥80 cm for women. We examined the association of triglyceride waist phenotypes with decreased eGFR risk using the weighted logistic regression models.Results: A total of 31,296 adults were included in this study. Compared with normal TG level/normal WC (NTNW) phenotype, normal TG level/enlarged WC (NTGW), elevated TG level/normal WC (HTNW), elevated TG level/enlarged WC (HTGW) were associated with the increased risk of decreased eGFR, with an multivariable-adjusted ORs (95% CI) of 1.77 (1.42-2.20), 1.48 (1.16-1.90), and 2.30 (1.80-2.93), respectively. These positive associations between triglyceride waist phenotypes and decreased eGFR risk remained across almost all the subgroups, including sex, age, BMI, T2DM, and hypertension. NTGW, HTNW, and HTGW phenotype were consistently positively associated with the risk of mildly and moderately decreased eGFR, but not with severely decreased eGFR risk.Conclusions: HTGW was consistently associated with the increased risk of decreased eGFR and various decreased eGFR stages except for severely decreased eGFR. The findings imply that HTGW may be an important risk factor for renal dysfunction or an indicator for prevention and control aiming to reduce renal function decline.

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Metabolites in the association between early-life famine exposure and type 2 diabetes in adulthood over a 5-year follow-up period

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001935 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001935

Author(s):

Yuying Wang ◽

Fangzhen Xia ◽

Heng Wan ◽

Chi Chen ◽

Yi Chen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Early Life ◽

Diabetes Risk ◽

Exposed Group ◽

Cross Sectional ◽

Metabolomic Profiling ◽

Diabetes Development ◽

Famine Exposure ◽

Design And Methods

IntroductionExposure to malnutrition in early life has been found to significantly elevate type 2 diabetes risk in adulthood. However, the changes in metabolites resulting from malnutrition in early life have not been studied. The aim of this study was to identify metabolites with levels associated with type 2 diabetes resulting from exposure to China’s Great Famine (1959–1962).Research design and methodsParticipants were from SPECT-China 2014 and SPECT-China2 2019, two cross-sectional studies performed at the same site. In total, 2171 subjects participated in SPECT-China and SPECT-China2 simultaneously. The sample size of fetal-exposed (1959–1962) versus non-exposed (1963–1974) individuals was 82 vs 79 in 2014 and 97 vs 94 in 2019. Metabolomic profiling was performed between famine-exposed and non-exposed groups.ResultsAmong the different famine exposure groups, the fetal-exposed group (1959–1962) had the greatest incidence rate (12.5%), with an OR of 2.11 (95% CI 1.01 to 4.44), compared with the non-exposed group (1963–1974). Moreover, compared with those in the non-exposed group (1963–1974), four metabolites (indole-3-carbinol (I3C), phosphatidylcholine (PC) (22:6(4Z,7Z,10Z,13Z,16Z,19Z)/16:1(9Z)), pyrimidine, and PC(16:1(9Z)/22:5(4Z,7Z,10Z,13Z,16Z))) showed significantly lower relative intensities in the famine and diabetes groups both in 2014 and 2019. Pyrimidine significantly mediated the association of famine exposure with diabetes, and I3C marginally mediated this association.ConclusionsFamine exposure in the fetal period could increase type 2 diabetes risk in adults, even those in their 60s. I3C and pyrimidine are potential mediators of the effects of famine exposure on diabetes development.

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Association between the Great China Famine exposure in early life and risk of arthritis in adulthood

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-210334 ◽

2018 ◽

Vol 72 (9) ◽

pp. 790-795 ◽

Cited By ~ 2

Author(s):

Zhenghe Wang ◽

Zhiyong Zou ◽

Bin Dong ◽

Jun Ma ◽

Luke Arnold

Keyword(s):

Early Life ◽

Weight Control ◽

Later Life ◽

Elevated Risk ◽

Exposed Group ◽

Nutrition Intervention ◽

Control Group ◽

Increased Risk ◽

Famine Exposure ◽

Stratified Analysis

BackgroundThe association between famine exposure in early life and risk of arthritis (combination of osteoarthritis and inflammatory arthritis) in adulthood is unclear. The aim of this study is to explore the association.MethodsA total of 4124 subjects were selected from the national data of the China Health and Retirement Longitudinal Study in 2011–2012. Doctor-diagnosed arthritis was self-reported in participants’ questionnaire. Birthdates were used to categorise participants into famine-exposed and non-exposed groups. Logistic regression model was used to explore the association of famine exposure in early life with the risk of arthritis in adulthood.ResultsThe prevalence of arthritis in both infant-exposed and preschool-exposed groups was significantly higher than those in the non-exposed group (35.0% and 30.6% vs 27.3%; p<0.05). Compared with the non-exposed group, the infant-exposed group showed a significantly elevated risk of arthritis in adulthood after adjusting for confounding factors (OR=1.65; 95% CI 1.29 to 2.11; p<0.001). In the stratified analysis, we found that participants who lived in severely affected areas (OR=1.91; 95% CI 1.41 to 2.59; p<0.001), who are female (OR=2.21; 95% CI 1.57 to 3.11; p<0.001) and those with a body mass index ≥24.0 kg/m2 (OR=2.46; 95% CI 1.70 to 3.55; p<0.001) in the infant-exposed group had increased risk of arthritis in adulthood. Similar results were additionally observed when age-balanced control group was used.ConclusionGreat China Famine exposure in infancy may be associated with an elevated risk of arthritis in adulthood, particularly in women and participants with adiposity. These findings suggest nutrition intervention in infancy and weight control in later life may reduce the risk of arthritis in adulthood.

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Famine Exposure in Early Life and Risk of Metabolic Syndrome in Adulthood: Comparisons of Different Metabolic Syndrome Definitions

Journal of Diabetes Research ◽

10.1155/2019/7954856 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Feng Ning ◽

Jie Ren ◽

Xin Song ◽

Dong Zhang ◽

Li Liu ◽

...

Keyword(s):

Metabolic Syndrome ◽

Early Life ◽

International Diabetes Federation ◽

Later Life ◽

Childhood And Adolescence ◽

Marginal Effect ◽

Odds Ratios ◽

Increased Risk ◽

Famine Exposure ◽

Adult Exposure

This study examined the association between famine exposure in early life and the risk of metabolic syndrome (MetS) in adulthood during the 1959–1961 Chinese Famine. Two cross-sectional surveys involving randomly selected Chinese adults aged 35–74 years in the Qingdao area were conducted. A total of 9,588 individuals were grouped into four birth cohorts of unexposed (born between January 1, 1962, and December 31, 1975), fetal-exposed (born between January 1, 1959, and December 31, 1961), childhood-exposed (born between January 1, 1949, and December 31, 1958), and adolescence/adult-exposed cohorts (born between January 1, 1931, and December 31, 1948). We assessed the prevalence rate of MetS in relation to famine exposure according to three definitions of MetS by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF), and China Diabetes Society (CDS). According to the CDS criterion, the prevalence rates of MetS were 17.8%, 25.7%, 31.1%, and 45.3% in the unexposed, fetal-, childhood-, and adolescence/adult-exposed cohorts, respectively (P<0.001). For the CDS criteria, compared with individuals without famine exposure, odds ratios (95% confidence interval) for MetS were 1.36 (1.02–1.81), 1.36 (1.06–1.75), and 1.60 (1.06–2.41) in women and 1.10 (0.79–1.53), 1.07 (0.79–1.42), and 1.21 (0.74–1.99) in men who were exposed in the fetal, childhood, and adolescence/adult periods, respectively, after adjustment for age, study cohorts, residential areas, education levels, income levels, current smoking, and current drinking. The same trend was observed in fetal and childhood exposure for the NCEP-ATP III and IDF definitions, except for a marginal effect in adolescence/adult exposure. Sensitivity analysis revealed that the odds ratios for MetS prevalence for the CDS definition were 1.37 (1.03–1.82), 1.40 (1.09–1.79), and 1.58 (1.04–2.40) among fetal, childhood, and adolescence/adult exposure in rural areas, respectively. The CDS definition is superior to the other definitions for determining the association between famine exposure and MetS with respect to early life. Famine exposure in early life is associated with an increased risk of MetS in later life, especially in women. Early-life malnutrition and later life overnutrition were critical in determining adulthood metabolic disorders.

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Early-Life Exposure to Famine and Risk of MetabolicAssociated Fatty Liver Disease in Chinese Adults

Nutrients ◽

10.3390/nu13114063 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4063

Author(s):

Jing Liu ◽

Guimin Wang ◽

Yiling Wu ◽

Ying Guan ◽

Zhen Luo ◽

...

Keyword(s):

Type 2 Diabetes ◽

Liver Disease ◽

Fatty Liver ◽

Early Life ◽

Fatty Liver Disease ◽

Chinese Adults ◽

Early Life Exposure ◽

Increased Risk ◽

Famine Exposure

Background: Early-life exposure to the Chinese famine has been related to the risk of obesity, type 2 diabetes, and nonalcoholic fatty liver disease later in life. Nevertheless, the long-term impact of famine exposure on metabolic associated fatty liver disease (MAFLD), a recently proposed term to describe liver disease associated with known metabolic dysfunction, remains unknown. The aim of our study was to explore the relationship between early famine exposure and MAFLD in adulthood. Methods: A total of 26,821 participants (10,994 men, 15,827 women) were recruited from a cohort study of Chinese adults in Shanghai. We categorized participants into four famine exposure subgroups based on the birth year as nonexposed (1963–1967), fetal-exposed (1959–1962), childhood-exposed (1949–1958), and adolescence-exposed (1941–1948). MAFLD was defined as liver steatosis detected by ultrasound plus one of the following three criteria: overweight/obesity, type 2 diabetes, or evidence of metabolic dysregulation. Multivariable logistic regression models were performed to examine the association between famine exposure and MAFLD. Results: The mean ± standard deviation age of the participants was 60.8 ± 6.8 years. The age-adjusted prevalence of MAFLD was 38.3, 40.8, 40.1, and 36.5% for the nonexposed, fetal-exposed, childhood-exposed, and adolescence-exposed subgroups, respectively. Compared with nonexposed participants, fetal-exposed participants showed an increased risk of adulthood MAFLD (OR = 1.10, 95% CI 1.00–1.21). The significant association between fetal famine exposure and MAFLD was observed in women (OR = 1.22, 95% CI 1.08–1.37), but not in men (OR = 0.88, 95% CI 0.75–1.03). In age-balanced analyses combining pre-famine and post-famine births as the reference, women exposed to famine in the fetal stage still had an increased risk of MAFLD (OR = 1.15, 95% CI 1.05–1.26). Conclusions: Prenatal exposure to famine showed a sex-specific association with the risk of MAFLD in adulthood.

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Early-life exposure to the Chinese famine of 1959–61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study

BMC Public Health ◽

10.1186/s12889-019-8017-1 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Wenqiang Zhang ◽

Rongsheng Luan

Keyword(s):

Early Childhood ◽

Uric Acid ◽

Longitudinal Study ◽

Serum Uric Acid ◽

Early Life ◽

Early Life Exposure ◽

Long Term Effect ◽

Increased Risk ◽

Famine Exposure

Abstract Background Short-term starvation has been related to hyperuricemia. However, little is known about the long-term effect of early-life exposure to famine on hyperuricemia risk in adulthood. Methods The analysis included 2383 participants from the China Health and Retirement Longitudinal Study in 2015. Hyperuricemia was diagnosed as serum uric acid ≥7 mg/dL in men and serum uric acid ≥6 mg/dL in women. Famine exposure subgroups were defined as unexposed (born between October 1, 1962, and September 30, 1964), fetal-exposed (born between October 1, 1959, and September 30, 1961), and early-childhood exposed (born between October 1, 1956, and September 1, 1958). The association between early-life famine exposure and hyperuricemia risk was assessed using multivariate logistic regression. Results The prevalence of hyperuricemia in the unexposed, fetal-exposed, and early-childhood exposed participants was 10.7, 14.1, 11.1%, respectively. Compared with unexposed and early-childhood exposed participants combined as an age-balanced control, fetal-exposed participants showed an increased risk of hyperuricemia in adulthood (OR = 1.41; 95% CI: 1.06–1.88), after adjusting for gender, marital status, famine severity, residence, smoking, drinking, BMI, hypertension, and diabetes. The famine effect on hyperuricemia was accentuated by overweight or obesity (P for interaction = 0.042). Compared with unexposed and BMI < 24 kg/m2 participants, the OR (95%CI) of hyperuricemia was 3.66 (2.13–6.30) for fetal-exposed and overweight/obesity participants. However, combined unexposed and early-childhood exposed participants as an age-balanced control, the interaction of famine exposure and BMI was not statistically significant (P for interaction = 0.054). Conclusion Famine exposure in the fetal stage was associated with an increased risk of hyperuricemia in adulthood.

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Exposure to second-hand smoke during early life and subsequent sleep problems in children: a population-based cross-sectional study

Environmental Health ◽

10.1186/s12940-021-00793-0 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Li-Zi Lin ◽

Shu-Li Xu ◽

Qi-Zhen Wu ◽

Yang Zhou ◽

Hui-Min Ma ◽

...

Keyword(s):

Early Life ◽

Sleep Problems ◽

Population Based ◽

Cross Sectional Study ◽

Liaoning Province ◽

Second Hand Smoke ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Shs Exposure

Abstract Background Previous studies have revealed that current secondhand smoke exposure showed highly suggestive evidence for increased risk of simultaneous sleep problems in children. Data on the associations between early-life exposure to SHS with subsequent sleep problems in children were scarce. We aimed to evaluate the associations of early-life SHS exposure with sleep problems in children. Methods In this cross-sectional study, children were recruited from elementary and middle schools in Liaoning Province, China between April 2012 and January 2013. We assessed early-life SHS exposure (pregnancy and the first 2 years of life) via questionnaires. Sleep problems and different types of sleep-related symptoms were measured based on the validated tool of the Sleep Disturbance Scale for Children (SDSC). Generalized linear mixed models were applied to estimate the associations of early-life SHS exposure with sleep problems. Results We included a total of 45,562 children (22,657 [49.7%] males; mean [SD] age, 11.0 [2.6] years) and 6167 of them (13.5%) were exposed to early-life SHS during both pregnancy and the first 2 years of life. Compared with unexposed counterparts, children exposed to early-life SHS had higher total T-scores of SDSC (β = 4.32; 95%CI: 4.06, 4.58) and higher odds of increased sleep problems (OR = 2.14; 95%CI: 1.89, 2.42). When considering different sleep-related symptoms, the associations between early-life SHS exposure and symptom of sleep-wake transition disorders (i.e., bruxism) were the strongest in all analyses. Conclusions Early-life SHS exposure was associated with higher odds of global sleep problems and different sleep-related symptoms in children aged 6–18 years. Our findings highlight the importance to strengthen efforts to support the critical importance of maintaining a smoke-free environment especially in early life.

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Cardiometabolic Traits Mediated the Relationship from Early Life Famine Exposure to Adulthood Nonalcoholic Fatty Liver Disease Risk

British Journal Of Nutrition ◽

10.1017/s0007114521003342 ◽

2021 ◽

pp. 1-27

Author(s):

Xu Han ◽

Jing Wang ◽

Yaru Li ◽

Dongsheng Hu ◽

Meian He

Keyword(s):

Liver Disease ◽

Mediation Analysis ◽

Early Life ◽

Fatty Liver Disease ◽

Exposed Group ◽

Nonalcoholic Fatty Liver ◽

Early Life Exposure ◽

Famine Exposure ◽

The Relationship ◽

Cardiometabolic Traits

Abstract Early life exposure to famine was associated with adulthood metabolic syndrome and nonalcoholic fatty liver disease (NAFLD), and NAFLD was also affected by cardiometabolic traits. However, the role of cardiometabolic traits in the associations from famine exposure to NAFLD was largely unknown. This study aimed to investigate whether the relationship between early life famine exposure and adulthood NAFLD risk was mediated by cardiometabolic traits. Overall, 7,578 subjects aged 56.0 ± 3.7 years in the Dongfeng-Tongji cohort were included and classified into late-exposed (1952-1954), middle-exposed (1954-1956), early-childhood-exposed (1956-1958), fetal-exposed (1959-1961), and nonexposed (1962-1966, reference) group according to the birth year. NAFLD was diagnosed by experienced physicians via abdominal B-type ultrasound inspection. Mediation analysis was used to evaluate the mediating effects of cardiometabolic traits. Compared with those nonexposed, after multivariable adjustment, participants in fetal-exposed group (OR: 1.37; 95% CI: 1.08-1.73) had 37% higher risk to develop NAFLD, and the overall childhood-exposed group had marginally significant association with NAFLD (OR: 1.39; 95% CI: 0.99-1.94). Stratification analysis found the famine-NAFLD associations more evident in women and those born in areas severely affected by famine. Mediation analysis showed that cardiometabolic traits such as TC, TyG index, γ-GT, ALP, and ALT mediated 6.7%-22.2% of the relation from famine exposure to higher NAFLD risk. Early life exposure to famine was related to increased adulthood NAFLD risk, and this relationship was partly mediated by cardiometabolic traits.

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