Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China.
Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China.
Biomed Res Int. 2021 Sep 23;2021:5594718. doi: 10.1155/2021/5594718. eCollection 2021.
Undernutrition early in life may increase the incidence of adverse effects on adult health. The relations between undernutrition and obesity parameters (body mass index (BMI) and WC (waist circle)) and hypertension were often contradictory. Our study is aimed at identifying the combined effects of famine exposure and obesity parameters on hypertension in middle-aged and older Chinese.
A population-based cross-sectional study. . Data were selected from the China Health and Retirement Longitudinal Study Wave2011 (CHARLS Wave2011). . The sample included 12945 individuals aged 45 to 96. . The study analyzed data from 12945 middle-aged and older Chinese selected from CHARLS Wave2011. Differences between baseline characteristics and famine exposure/BMI levels/WC levels were evaluated using the -, Chi-square- ( -), and -test. Then, the difference in the prevalence of hypertension between baseline characteristics was estimated by the - and -test. Finally, multivariable-adjusted logistic regression models were used to explore the associations of famine exposure and obesity parameters with odds of prevalence of hypertension.
Among the 12945 participants, 1548 (11.96%) participants had been exposed to the Chinese famine during the fetal group, whereas 5101 (39.41%) participants and 4362 (33.70%) participants had been exposed to the famine during childhood and adolescence/adult group, respectively. Regarding the participants with BMI levels, 3746 (28.94%) were overweight, and 1465 (11.32%) were obese, whereas 5345 (41.29%) of the participants with WC levels were obese, respectively. Furthermore, 1920 (31.17%) had hypertension in males and 2233 (32.91%) in females. In multivariable-adjusted models, famine exposure and obesity parameters were related with prevalence of hypertension independently in total populations ((1) model three, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.27; 95% CI 1.08, 1.49); childhood-exposed vs. no-exposed group (OR1.64; 95% CI 1.44, 1.87); the adolescence/adult-exposed vs. no-exposed group (OR3.06; 95% CI 2.68, 3.50); for trend < 0.001; (2) model three, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.25; 95% CI 1.06, 1.47); childhood-exposed vs. no-exposed group (OR1.52; 95% CI 1.34, 1.73); the adolescence/adult-exposed vs. no-exposed group (OR2.66; 95% CI 2.33, 3.03); for trend < 0.001; (3) model three, BMI levels with prevalence of hypertension: overweight vs. normal (OR1.75; 95% CI 1.60, 1.91); obesity vs. normal (OR2.79; 95% CI 2.48, 3.15); for trend < 0.001; (4) WC levels with prevalence of hypertension: overweight vs. normal (OR1.42; 95% CI 1.36, 1.48)). When stratified by sex, results in both males and females were mostly similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal BMI/WC levels and no-exposed famine group, all groups trended towards higher odds of prevalence of hypertension (the greatest increase in odds, adolescence/adult-exposed group with obesity in BMI levels: (OR8.13; 95% CI 6.18, 10.71); adolescence/adult-exposed group with obesity in WC levels: (OR6.36; 95% CI 5.22, 7.75); for interaction < 0.001). When stratified by sex, the results in both males and females were also similar to those in the total population.
Our data support a strongly positive combined effect of famine exposure and obesity parameters on hypertension in middle-aged and elderly Chinese.
生命早期的营养不良可能会增加对成年健康产生不良影响的发生率。营养不良与肥胖参数（体重指数（BMI）和腰围（WC））和高血压之间的关系常常相互矛盾。我们的研究旨在确定饥荒暴露和肥胖参数对中国中老年人群高血压的综合影响。
基于人群的横断面研究。从中国健康与退休纵向研究（CHARLS Wave2011）中选择数据。样本包括 45 至 96 岁的 12945 人。研究分析了从 CHARLS Wave2011 中选择的 12945 名中国中老年人的数据。使用 -检验、卡方检验（-检验）和 -检验评估基线特征和饥荒暴露/BMI 水平/WC 水平之间的差异。然后，通过 -检验和 -检验估计基线特征之间高血压患病率的差异。最后，使用多变量调整的逻辑回归模型探讨饥荒暴露和肥胖参数与高血压患病率之间的关联。
在 12945 名参与者中，1548 名（11.96%）参与者在胎儿组中曾经历过中国饥荒，而 5101 名（39.41%）和 4362 名（33.70%）参与者分别在儿童期和青少年/成年期经历过饥荒。关于 BMI 水平的参与者，3746 名（28.94%）超重，1465 名（11.32%）肥胖，而 WC 水平的 5345 名参与者（41.29%）肥胖，分别。此外，男性中有 1920 名（31.17%）患有高血压，女性中有 2233 名（32.91%）患有高血压。在多变量调整模型中，饥荒暴露和肥胖参数与总人群中高血压患病率独立相关（1）模型三，饥荒暴露与高血压患病率：致命暴露组与无暴露组（OR1.27；95%CI 1.08，1.49）；儿童期暴露组与无暴露组（OR1.64；95%CI 1.44，1.87）；青少年/成年期暴露组与无暴露组（OR3.06；95%CI 2.68，3.50）；趋势检验<0.001；（2）模型三，饥荒暴露与高血压患病率：致命暴露组与无暴露组（OR1.25；95%CI 1.06，1.47）；儿童期暴露组与无暴露组（OR1.52；95%CI 1.34，1.73）；青少年/成年期暴露组与无暴露组（OR2.66；95%CI 2.33，3.03）；趋势检验<0.001；（3）模型三，BMI 水平与高血压患病率：超重与正常（OR1.75；95%CI 1.60，1.91）；肥胖与正常（OR2.79；95%CI 2.48，3.15）；趋势检验<0.001；（4）WC 水平与高血压患病率：超重与正常（OR1.42；95%CI 1.36，1.48））。按性别分层后，男性和女性的结果与总体人群的结果大多相似。一般来说，多变量调整模型中的交互分析表明，与正常 BMI/WC 水平和无饥荒暴露组的组合相比，所有组的高血压患病率均呈上升趋势（最大上升幅度，BMI 水平肥胖的青少年/成年期暴露组：（OR8.13；95%CI 6.18，10.71）；WC 水平肥胖的青少年/成年期暴露组：（OR6.36；95%CI 5.22，7.75）；趋势检验<0.001）。按性别分层后，男性和女性的结果也与总体人群相似。
我们的数据支持在中国中老年人群中，饥荒暴露和肥胖参数对高血压有强烈的综合影响。
