Xu Xianglong, Liu Lingli, Xie Wenxi, Zhang Yong, Zeng Huan, Zhang Fan, Reis Cesar, Cao Xianqing, Zhao Yong
School of Public Health and Management Research Center for Medicine and Social Development The Innovation Center for Social Risk Governance in Health School of the Second Clinical, Chongqing Medical University, Chongqing, China Department of Preventive Medicine, Loma Linda University Medical Center, CA.
Medicine (Baltimore). 2017 Mar;96(13):e6496. doi: 10.1097/MD.0000000000006496.
The developmental origins hypothesis postulates that under-nutrition in the early stage of life is associated with an increased risk of disease in adulthood. This study aimed to examine the association of exposure to the Chinese famine of 1959 to 1961 in early life with the risk of arthritis in adulthood.From July to September 2009, the study adopted multistage stratified random sampling cross-sectional survey to recruit 1224 eligible adults in Chongqing. Famine exposure groups were categorized into 3 groups: (1) childhood exposure, (2) fetal exposure, and (3) nonexposure. Self-reported arthritis of physician diagnosis was obtained. A total of 1224 eligible respondents were interviewed, including 299 individuals exposed during childhood, 455 exposed when fetal, and 470 without exposure.The prevalence of arthritis in adulthood among individuals exposed to famine during childhood was significantly higher than those not exposed (17.39% vs 11.28%, odds ratio [OR] = 1.573 with a 95% confidence interval of [CI] [1.020, 2.424]). Persons exposed to famine during the fetal period did not significantly contribute to a higher rate of arthritis in adulthood than those who were not exposed to famine (13.19% vs 11.28%, OR = 1.072, 95% CI = 0.713, 1.613). In addition, education level, the average monthly income, sleep status, and satisfaction of the present living condition were associated with the risk of arthritis in adulthood.Exposure to the Chinese famine during childhood may be associated with an increased risk of arthritis in adulthood. This study suggests that early life nutrition may have an effect on the risk of arthritis in adulthood.
发育起源假说假定，生命早期的营养不足与成年后患疾病的风险增加有关。本研究旨在探讨生命早期经历1959年至1961年中国饥荒与成年后患关节炎风险之间的关联。2009年7月至9月，该研究采用多阶段分层随机抽样横断面调查，在重庆招募了1224名符合条件的成年人。饥荒暴露组分为3组：（1）儿童期暴露，（2）胎儿期暴露，（3）未暴露。获取了经医生诊断的自我报告的关节炎情况。共采访了1224名符合条件的受访者，其中包括299名儿童期暴露者、455名胎儿期暴露者和470名未暴露者。儿童期暴露于饥荒的个体成年后患关节炎的患病率显著高于未暴露者（17.39%对11.28%，优势比[OR]=1.573，95%置信区间[CI][1.020,2.424]）。胎儿期暴露于饥荒的人群成年后患关节炎的比例相较于未暴露于饥荒的人群，并未显著升高（13.19%对11.28%，OR=1.072，95%CI=0.713,1.613）。此外，教育水平、月平均收入、睡眠状况和对当前生活条件的满意度与成年后患关节炎的风险相关。儿童期经历中国饥荒可能与成年后患关节炎的风险增加有关。本研究表明，生命早期的营养状况可能会影响成年后患关节炎的风险。
