The Association Between Exposure To Chinese Famine In Early Life And The Risk Of Hypertension And Dyslipidemia In Adulthood

Objective: Studies have shown that early life famine exposure was associated with increased risks of hypertension and dyslipidemia.However,the epidemiological studies on the relationship between famine exposure and hypertension and dyslipidemia are controversial.Therefore,the purpose of this study is to explore the association between early life famine exposure and hypertension and dyslipidemia,and to study the relative importance of early life famine exposure on hypertension and dyslipidemia,so as to provide scientific basis for the prevention of these two diseases.Methods: This is a cross-sectional study and we use data derived from the 2009 China Health and Nutrition Survey(CHNS).It use a multistage,random cluster process to draw a sample of about 30000 individuals in 15 provinces and municipal cities that vary substantially in geography,economic development,public resource,and health indicators.A total of 4653 subjects were included.Based on their date of birth,Participants who were born in 1959-1961 were categorized into fetal-infant exposed group(n=410),participants who were born in 1949-1958 were categorized into childhood exposure group(n=2057),participants who were born in 1941-1948 were categorized into adolescence exposed group(n=1103),and participants who were born in 1962-1966 were categorized into the unexposure group(n=1083).For continuous variables,group differences were tested using Student’s t test.Wilcoxon rank sum test was used to test difference in skewed parameters.The chi-square test was performed to compare differences across groups for categorical variables.We compared fetal exposed group,childhood exposed group and adolescence exposed group to unexposed group using logistic regression models to assess the effect of famine exposure on later hypertension and dyslipidemia.Dominance analysis was used to investigate the relative importance of the famine exposure affecting hypertension and dyslipidemia.Statistical analyses were performed using SPSS 18.0 and Stata 15.0.All the analyses were two-sided,and P ≤ 0.05 was considered significant.Results: A total of 4653 subjects were included in our study.The crude ORs(95% CIs)of hypertension in fetal,childhood and adolescence groups were 1.29(1.00-1.66),1.72(1.45-2.02),and 2.89(2.41-3.47),respectively.After adjustment for sex,BMI,smoking,drinking,physical activity,nationality,education,residence place dyslipidemia,diabetes,the corresponding ORs(95% CIs)were 1.27(0.97-1.66),1.79(1.50-2.14)and 3.11(2.53-3.83),respectively.For dyslipidemia,the crude ORs(95% CIs)in fetal,childhood and adolescence groups were 1.44(1.14-1.83),1.39(1.19-1.61)and 1.36(1.14-1.61),as compared with unexposed group.After adjustment for confounders,similar and statistically significant results were found in fetal,childhood and adolescence groups,and the corresponding OR(95% CIs)were 1.35(1.06-1.73),1.38(1.17-1.63)and 1.25(1.03-1.52),respectively.The relative important predictor for hypertension was BMI(53.45%),famine exposure(29.49%),dyslipidemia(8.02%),diabetes(6.22%)and gender(2.83%).The relative important predictor for dyslipidemia was BMI(52.87%),diabetes(18.23%),physical activity(15.35%),hypertension(9.35%)and famine exposure(4.19%).Conclusion: Our study showed that exposure to famine during early life was associated with increased the risk of later hypertension and dyslipidemia,and increased the levels of blood pressure and serum lipids in Chinese population.Thus,we should pay much attention to the prevention of malnutrition during early life for reducing hypertension and dyslipidemia risk.