Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Department of Endocrinology, the Fifth Affiliated Hospital of Kunming Medical University, Yunnan Honghe Prefecture Central Hospital (Ge Jiu People's Hospital), Yunnan, China.
J Clin Endocrinol Metab. 2020 Nov 1;105(11). doi: 10.1210/clinem/dgaa523.
The double burden of malnutrition (DBM), undernutrition in early life and an obesogenic environment later on, influences later risk of chronic disorders. The Great Famine in China from 1959 to1962 and remarkable economic development from the 1980s provided such a burden for a large number of people in their 60s.
We aimed to analyze the effect of economic status on the association between famine exposure in early life and hyperuricemia in adulthood.
Participants numbering 12 666 were enrolled in China based on the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Study from 2014 to 2016.
Participants with fetal or childhood famine exposure (birth year 1949-1962) formed the exposure group.
Hyperuricemia was defined as uric acid (UA) > 420 μmol/L for men and > 360 μmol/L for women. The association of famine with hyperuricemia was assessed via regression analyses.
Early-life famine exposure was negatively associated with UA levels (P = .045) but was not associated with hyperuricemia (P = .226) in the whole study population. Economic status could moderate the association of famine exposure with UA and hyperuricemia (P ≤ .001). In participants with high economic status, early-life famine exposure was positively associated with UA levels (unstandardized coefficients 7.61, 95% CI 3.63-11.59, P < .001), and with hyperuricemia (odds ratio 1.47, 95% CI 1.19-1.81, P < .001).
Economic status could moderate the association between exposure to famine in early life and hyperuricemia in adulthood, indicating that the DBM might affect hyperuricemia in an opposite direction of the effects of undernutrition in early life alone.
营养不良的双重负担（DBM），即生命早期的营养不足和后来的致肥胖环境，会影响以后发生慢性疾病的风险。1959 年至 1962 年的中国大饥荒和 20 世纪 80 年代以来显著的经济发展，使许多 60 多岁的人承受了这样的负担。
我们旨在分析经济状况对生命早期饥荒暴露与成年期高尿酸血症之间关联的影响。
参与者共有 12666 人，他们于 2014 年至 2016 年参加了基于中国东部代谢性疾病和危险因素调查（SPECT-China）的研究。
有胎儿或儿童期饥荒暴露（出生年份为 1949 年至 1962 年）的参与者构成暴露组。
高尿酸血症定义为尿酸（UA）>420 μmol/L 男性和>360 μmol/L 女性。通过回归分析评估饥荒与高尿酸血症的关系。
在整个研究人群中，生命早期的饥荒暴露与 UA 水平呈负相关（P=0.045），但与高尿酸血症无关（P=0.226）。经济状况可以调节饥荒暴露与 UA 和高尿酸血症的关联（P≤0.001）。在经济状况较高的参与者中，生命早期的饥荒暴露与 UA 水平呈正相关（未标准化系数为 7.61，95%CI 为 3.63-11.59，P<0.001），与高尿酸血症呈正相关（比值比为 1.47，95%CI 为 1.19-1.81，P<0.001）。
经济状况可以调节生命早期暴露于饥荒与成年期高尿酸血症之间的关联，这表明 DBM 可能以与单纯生命早期营养不良相反的方向影响高尿酸血症。
