School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China.
Population Health, South Western Sydney Primary Health Network, Sydney, New South Wales, Australia.
J Epidemiol Community Health. 2018 Sep;72(9):790-795. doi: 10.1136/jech-2017-210334. Epub 2018 Apr 21.
The 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.
A 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.
The 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/m (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.
Great 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.
生命早期饥荒暴露与成年后关节炎（骨关节炎和炎症性关节炎的组合）风险之间的关系尚不清楚。本研究旨在探讨这种关联。
本研究共从 2011-2012 年中国健康与退休纵向研究的全国数据中选择了 4124 名受试者。参与者在问卷中自我报告了医生诊断的关节炎。根据出生日期将参与者分为暴露于饥荒和未暴露于饥荒的两组。使用逻辑回归模型探讨生命早期饥荒暴露与成年后关节炎风险之间的关系。
婴儿期暴露组和幼儿期暴露组的关节炎患病率明显高于未暴露组（35.0%和 30.6%比 27.3%；p<0.05）。在校正混杂因素后，与未暴露组相比，婴儿期暴露组成年后患关节炎的风险显著升高（OR=1.65；95%CI 1.29 至 2.11；p<0.001）。在分层分析中，我们发现生活在受灾严重地区的参与者（OR=1.91；95%CI 1.41 至 2.59；p<0.001）、女性（OR=2.21；95%CI 1.57 至 3.11；p<0.001）和婴儿期暴露组中 BMI≥24.0kg/m 的参与者（OR=2.46；95%CI 1.70 至 3.55；p<0.001）成年后患关节炎的风险增加。当使用年龄匹配的对照组时，也观察到了类似的结果。
中国大饥荒时期的婴儿期暴露可能与成年后患关节炎的风险增加有关，特别是在女性和肥胖参与者中。这些发现表明，婴儿期的营养干预和成年后的体重控制可能会降低成年后患关节炎的风险。
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