Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar.
Transformation & Operation, Deloitte, Canberra, ACT 2609, Australia.
Nutrients. 2022 Mar 3;14(5):1060. doi: 10.3390/nu14051060.
This study focused on identifying whether exposure to the Chinese Great Famine (1959-1961) in early life amplified the potential for fractures in adulthood. The survey was conducted using data from the 1997-2015 China Health and Nutrition Survey (CHNS)-5235 adults born between 1954 and 1964 were selected as the sample size. Fracture was defined based on self-report. Those born from 1962-1964 were treated as non-exposure group. Those with exposure to famine were divided into four subgroups: Fetal, early childhood, mid-childhood, and late childhood cohorts. The association between the groups and fracture was determined using Cox regression. In follow-up data (mean of 11 years), fractures were identified in 418 of the participants. The incidence of fracture was 8.7 in late childhood, 8.1 in mid-childhood, 8.3 in early childhood, 7.0 in fetal, and 5.4 in non-exposed cohorts per 1000 person-year. Compared with the non-exposed group, the famine-exposed groups had an increased risk of developing fracture in adulthood with hazard ratio (HR) and 95% CI of 1.29 (0.90-1.85), 1.48 (1.08-2.03), 1.45 (1.02-2.06), and 1.54 (1.08-2.20), respectively. The positive link of famine exposure to risk of fracture occurred primarily in those participants with a modern diet who lived in urban areas. In conclusion, the risk of fracture in Chinese adults is associated with famine exposure.
本研究旨在探讨个体在生命早期经历中国大饥荒（1959-1961 年）是否会增加其成年后患骨折的风险。该研究使用了 1997-2015 年中国健康与营养调查（CHNS）的数据，选取了 1954-1964 年出生的 5235 名成年人作为样本。骨折的定义基于自我报告。1962-1964 年出生的个体被视为非暴露组。暴露于饥荒的个体被分为四个亚组：胎儿期、婴幼儿期、儿童中期和儿童晚期队列。采用 Cox 回归分析确定各组与骨折的关系。在随访数据（平均 11 年）中，418 名参与者发生了骨折。骨折发生率为：晚期儿童队列为 8.7/1000 人年，中期儿童队列为 8.1/1000 人年，婴幼儿队列为 8.3/1000 人年，胎儿期队列为 7.0/1000 人年，非暴露组为 5.4/1000 人年。与非暴露组相比，暴露于饥荒的各组在成年后患骨折的风险增加，其风险比（HR）和 95%置信区间（CI）分别为 1.29（0.90-1.85）、1.48（1.08-2.03）、1.45（1.02-2.06）和 1.54（1.08-2.20）。饥荒暴露与骨折风险之间的正相关主要发生在那些饮食现代且居住在城市的参与者中。总之，中国成年人骨折的风险与饥荒暴露有关。
