Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Haidian District, 100142, Beijing, China.
Hua County People's Hospital, Anyang, Henan Province, China.
BMC Public Health. 2021 Nov 20;21(1):2129. doi: 10.1186/s12889-021-12211-8.
The association of early-life undernutrition and dyslipidemia found in previous studies may be confounded by the uncontrolled age difference between exposed and unexposed participants. The study aimed to investigate the association of early-life undernutrition and the risk of dyslipidemia in adulthood with good control of the age variable.
We took the Great Chinese Famine (1959-1961) as a natural experiment of severe undernutrition. This study was based on the baseline investigation of a population-based cohort in rural China. Undernutrition in early life was defined as being exposed to famine at younger than 3 years of age. Three approaches including Adjustment, Restriction, and Matching were applied to control the confounding effect of age. Logistic regression models were applied to evaluate the association between early-life famine and the presence of dyslipidemia. Stratified analysis by gender was also performed, and potential effect modification was tested by adding the interaction term of the famine exposure variable and gender into the model.
Undernutrition in early life was associated with increased risk of borderline high and above (BHA) levels of total cholesterol (TC, OR = 1.61; OR = 1.56; OR = 1.87), triglycerides (TG, OR = 1.33; OR = 1.30; OR = 1.34), low-density lipoprotein cholesterol (LDL-C, OR = 1.75; OR = 1.53; OR = 1.77) and dyslipidemia (OR = 1.52; OR = 1.45; OR = 1.60), as well as high levels of TC, TG, LDL-C and dyslipidemia. An inverse association of undernutrition and risk of low high-density lipoprotein cholesterol (HDL-C) was found. Female participants with undernutrition experience had an increased risk of BHA TG and LDL-C (TG: OR = 1.45; OR = 1.39; OR = 1.51; LDL-C: OR = 2.11; OR = 1.80; OR = 2.15), but this association was not found in males.
Early-life undernutrition increased the risk of TC, TG, LDL-C, and dyslipidemia. Gender would significantly modify this effect for TG and LDL-C. These results emphasize the importance of nutritional conditions in the early stages of life to long-term health consequences.
之前的研究表明，早期生活中的营养不良与血脂异常之间存在关联，但这可能受到暴露组和未暴露组参与者年龄差异的影响。本研究旨在通过控制年龄这一变量，探讨早期生活中的营养不良与成年后血脂异常风险之间的关联。
我们以 1959-1961 年中国大饥荒为严重营养不良的自然实验，基于中国农村一项基于人群的队列的基线调查。早期生活中的营养不良定义为在 3 岁之前经历饥荒。本研究采用调整法、限制法和匹配法来控制年龄的混杂效应。应用 logistic 回归模型评估早期生活中的饥荒与血脂异常之间的关系。并按性别进行分层分析，通过在模型中添加饥荒暴露变量和性别之间的交互项来检验潜在的效应修饰作用。
早期生活中的营养不良与总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和血脂异常的边缘高值及以上（BHA）水平升高相关（TC：OR=1.61；OR=1.56；OR=1.87；TG：OR=1.33；OR=1.30；OR=1.34；LDL-C：OR=1.75；OR=1.53；OR=1.77）。此外，早期生活中的营养不良与 TC、TG、LDL-C 和血脂异常的高值相关。而与高密度脂蛋白胆固醇（HDL-C）低值相关。女性营养不良组的边缘高值 TG 和 LDL-C 水平升高（TG：OR=1.45；OR=1.39；OR=1.51；LDL-C：OR=2.11；OR=1.80；OR=2.15），但在男性中未发现这种关联。
早期生活中的营养不良增加了 TC、TG、LDL-C 和血脂异常的风险。性别对 TG 和 LDL-C 有显著的修饰作用。这些结果强调了生命早期营养状况对长期健康后果的重要性。
