Exposure To The Chinese Famine In Early Life And Prevalence Risk Of Metabolic Syndrome And Hypertension In Adults

Metabolic syndrome(Met S)is characterized by a group of physiologically related cardiovascular risk factors,including central obesity,elevated blood pressure,dyslipidemia,and increased fasting plasma glucose.In addition,Met S is a serious public health epidemic worldwide and it is implicated with an increased risk of diabetes,cardiovascular disease,chronic kidney disease,and all-cause mortality.In China,the prevalence of Met S has been increasing rapidly and the age-standardized prevalence of Met S was 13.7%(9.8% in men and 17.8 in women).Smoking,drinking,physical activity,sedentary lifestyle,and genetic susceptibility are well-known risk factors for Met S,though other factors remain to be explored.In addition,previous famine studies lent support to the hypothesis that malnutrition in early life may participant in the origins of central obesity,elevated blood pressure,dyslipidemia,and hyperglycemia,which are the Met S components.China suffered the world’s largest famine between 1959 and 1961(about 3 years).The famine caused by natural and political factors,leading to the sharply decreasing of food supply.In addition,about 30 million people died during the famine.The developmental origins hypothesis suggests that undernutrition in early life elevates the risk of chronic disease including metabolic syndrome and its components in adulthood.However,the relationship between famine exposure in early life and Met S prevalence risk in adults was inconsistent.Previous findings from the Chinese famine studies indicated that famine exposure in early life increased the risk of Met S in adults,but the Dutch famine study did not find significant association between them.The Dutch famine study indicated that exposure to famine in fetal did not increase mean blood pressure or risk of hypertension in adults at age 50 but elevated systolic blood pressure(SBP)and increased risk of hypertension in adults at age 59.Findings from theNigerian famine and Leningrad Siege study showed that exposure to famine in early life elevated blood pressure and risk of hypertension prevalence in adults.Therefore,the present study mainly investigated the association between famine exposure in early life and metabolic syndrome prevalence risk in adults.Furthermore,we explored the association between famine exposure in early life and hypertension prevalence risk in adults.Part ? Exposure to the Chinese famine in early life and metabolic syndrome prevalence risk in adultsObjectives: Famine exposure in early life has been reported to be associated with higher risk of metabolic syndrome prevalence in adults.The aim of the present study was to investigate the association of exposure to the Chinese famine during early life with the risk of metabolic syndrome prevalence in adults.Methods: There were 7,915 participants born between 1952 and 1964 derived from the Dongfeng-Tongji cohort during the first follow-up included in the present study.Participants were classified as non-exposed group,fetal exposed group,early childhood-,mid childhood-,and late childhood-exposed groups,respectively.Logistic regression model was used to explore the association between famine exposure in early life and risk of metabolic syndrome prevalence in adults.Results: The prevalence of metabolic syndrome among individuals in non-,fetal-,early childhood-,mid childhood-,and late childhood-exposed groups were 25.2%,26.9%,30.3%,32.7%,and 32.7%,respectively.Compared with non-exposed group,participants exposed to famine in the early childhood(1.24,95% CI: 1.01-1.52),mid childhood(1.39,95% CI: 1.13-1.72),and late childhood(1.33,95% CI: 1.08-1.63)had higher risk of metabolic syndrome prevalence in adults after adjustment for potential confounders(P for trend <0.0001).In gender-specific analyses,women exposed to famine in early childhood(1.26,95% CI: 1.02-1.56),mid childhood(1.43,95% CI: 1.14-1.78),and late childhood(1.47,95% CI: 1.18-1.84)had a higher risk of metabolic syndrome prevalence risk than unexposed women.The association was not found in men.Conclusion: Results in the present study indicated that exposure to the famine in early life increases the risk of metabolic syndrome prevalence in adulthood.Part II Exposure to the Chinese famine in early life and hypertension prevalence risk in adultsObjectives: Famine exposure in early life has been reported to be associated with higher risk of hypertension prevalence in adults.The aim of the present study was to investigate the association of exposure to the Chinese famine during early life with the risk of hypertension prevalence in adults.Methods: There were 8,742 participants born between 1952 and 1964 derived from the Dongfeng-Tongji cohort included in the present study.Participants were classified as non-exposed group,fetal exposed group,early childhood-,mid childhood-,and late childhood-exposed groups,respectively.Logistic regression model was used to explore the association between famine exposure in early life and risk of hypertension prevalence in adults.Results: The prevalence of hypertension among individuals in non-,fetal-,early childhood-,mid childhood-,and late childhood-exposed groups were 34.0%,38.0%,43.9%,47.4%,and 54.4%,respectively.Compared with non-exposed group,participants exposed to famine in the fetal(1.24,95% CI: 1.01-1.51),early childhood(1.44,95% CI: 1.20-1.73),mid childhood(1.67,95% CI: 1.38-2.02),and late childhood(2.11,95% CI: 1.75-2.55)had higher risk of hypertension prevalence in adults after adjustment for potential confounders(P for trend < 0.0001).Adjustment for age did not materially change the results.Conclusion: Results in the present study indicated that exposure to the famine in early life increases the risk of hypertension prevalence in adulthood.In conclusion,our results suggest that exposed to famine in early life increased the risk of both metabolic syndrome and hypertension risk in adults.