Association Between Famine Exposure In Different Life Stages And Metabolic Syndrome In Middle-aged And Elderly People

Objectives To explore the association between famine exposure in different life stages and the risk of metabolic syndrome(MS)in middle-aged and elderly people.Methods Based on the survey data of REACTION in Lanzhou area,this study uses the method of cluster random sampling to select 10062 permanent residents aged between 40 and 75 years in Tianqingjiayuan community,Guangwumen community and Tieluxicunjiedao community of Lanzhou City in 2011.According to the strict inclusion and exclusion criteria,9404 cases were finally included as the study population.In this study,MS was defined by the International Diabetes Federation in 2005.In the aspect of data analysis,the study population was divided into MS group and non-MS group according to whether they had MS or not,and the baseline characteristics between the two groups were compared.At the same time,according to the date of birth and famine exposure,the subjects were divided into 7 groups: non-exposed group,fetal exposure group,early childhood exposure group,middle childhood exposure group,late childhood exposure group,puberty exposure group and early adulthood exposure group.The prevalence and baseline characteristics of MS in each group were compared.The risk factors of MS were screened by univariate analysis,and then a regression model was established by multi-factor Logistic to analyze the association between famine in different life stages and the risk of MS in middle-aged and elderly people.A stratified analysis was conducted according to gender and body mass index(BMI)to further explore the association between famine and MS and the interaction between famine and risk factors in different populations.Results1.The prevalence rate of MS in the total population was 45.33%.The prevalence rates of MS in unexposed group,fetal exposure group,early childhood exposure group,midchildhood exposure group,late childhood exposure group,puberty exposure group and early adulthood exposure group were 29.64%,33.33%,37.16%,41.94%,48.04%,56.10% and 57.76%,respectively.2.Univariate analysis showed that gender,BMI,education level,smoking history,drinking history,low physical activity,fruit,dairy products and meat intake were the risk factors of MS(P<0.05).3.Results of the multifactorial logistic analysis showed that after correcting for relevant confounders,the unexposed group was defined as the control group,the early childhood exposure group(OR=1.43,95% CI:1.17-1.75),the middle childhood exposure group(OR=1.78,95% CI:1.46-2.18),the late childhood exposure group(OR=2.38,95% CI.2.02-2.80),puberty exposure group(OR=3.23,95% CI:2.73-3.82)and early adulthood exposure group(OR=3.72,95% CI:3.05-4.55)all had a significantly increased risk of MS in middle-aged and elderly people(P<0.05).4.Stratified analysis of gender and BMI showed that,after adjusting for relevant confounders,there was a significant assoc iation between famine exposure at different life stages and an increased risk of MS in middle-aged and elderly people in females and non-overweight/obese compared to the unexposed group(P<0.05).In men,only the late childhood and early adulthood famine e xposure was significantly associated with the risk of MS(P<0.05).Famine in middle childhood,late childhood,adolescence and early adult hood was associated with a significantly increased risk of MS in middle and old age in overweight/obese people(P<0.05).There was a significant interaction between famine and gender on the risk of MS(P-interaction<0.05),but no significant interaction was found between famine and BMI on the risk of MS(P-interaction>0.05).Conclusions1.Experiencing famine in childhood,adolescence and early adulthood all increase the risk of MS in middle and old age,especially in adolescence and early adulthood.2.In the gender stratification,the association between the experience of famine at different life stages and the risk of MS in middle and old age was stronger in women.3.In the BMI stratification,non-overweight/obese people exposed to famine at different life stages were at higher risk of MS in middle and old age.