基于性别的差异：埃塞俄比亚大饥荒（1983-1985 年）对成年期高血压风险的产前暴露效应：一项历史队列研究。

Differential effect of prenatal exposure to the Great Ethiopian Famine (1983-85) on the risk of adulthood hypertension based on sex: a historical cohort study.

机构信息

Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia.

Department of Nutrition and Dietetics, College of Health Sciences, DebreTabor University, Debre Tabor, Ethiopia.

出版信息

BMC Womens Health. 2022 Jun 11;22(1):220. doi: 10.1186/s12905-022-01815-w.

DOI:10.1186/s12905-022-01815-w

PMID:35690760

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9188157/

Abstract

BACKGROUND

The consequence of the Great Ethiopian Famine (1983-1985) on mortality had been well documented. However, the long term assaults of the famine on adulthood health, particularly on the risk of hypertension, has never been documented. The aim of this study was twofold: to examine the association of prenatal-exposure to the Great Ethiopian Famine and hypertension in adulthood and investigate if there existed sex difference in the risk estimate.

METHODS

Participants were recruited using multistage stratified random sampling and grouped as prenatal famine exposed and non-exposed cohorts based on their reported date of birth and current age. Independent sample T test was employed to compare continuous outcomes between the groups. A multivariable logistic regression was used to examine the association between prenatal famine exposure and risk of hypertension in adults.

RESULTS

Compared to the non-exposed groups, prenatal famine exposed cohorts had higher systolic blood pressure by 1.05 mmHg, (95% CI 0.29, 4.42) and diastolic by 2.47 mmHg (95% CI 1.01, 3.95). In multivariable logistic regression analysis, both unadjusted (COR = 2.50; 1.575, 3.989) and adjusted model for covariates (OR: 2.306 95% CI (1.426, 3.72) indicated a positive association between prenatal famine exposure and the risk of adult hypertension. However, in sex disaggregated analysis, the positive association was only significant in females (AOR = 3.95 95% CI 1.76, 8.85) indicating nearly four folds of odds of hypertension among females, while the corresponding figure for males was not significant (AOR = 1.201 (0.69, 2.07).

CONCLUSIONS

Famine exposure during prenatal period could have differential impact on the development of hypertension based on sex, where adult exposed females had higher risk of hypertension as compared to males. Contextualized primary prevention programs with special focus on gender is critical undertaking in hunger spots and regions with historical famine.

摘要

背景

大埃塞俄比亚饥荒（1983-1985 年）对死亡率的影响已有充分记录。然而，饥荒对成年人健康的长期影响，特别是对高血压风险的影响，从未有过记录。本研究旨在：一是检验产前暴露于大埃塞俄比亚饥荒与成年后高血压的关联，并探讨风险估计是否存在性别差异；二是分析。

方法

采用多阶段分层随机抽样方法招募参与者，并根据报告的出生日期和当前年龄将其分为产前暴露于饥荒和未暴露于饥荒两组。采用独立样本 t 检验比较两组间连续变量的差异。采用多变量逻辑回归分析产前暴露于饥荒与成人高血压风险的关系。

结果

与未暴露组相比，产前暴露于饥荒组的收缩压高 1.05mmHg（95%CI：0.29，4.42），舒张压高 2.47mmHg（95%CI：1.01，3.95）。多变量逻辑回归分析显示，未调整（COR=2.50；95%CI：1.575，3.989）和调整协变量模型（OR：2.306，95%CI：1.426，3.72）均表明产前暴露于饥荒与成人高血压风险呈正相关。然而，在按性别分层分析中，这种正相关仅在女性中具有统计学意义（AOR=3.95，95%CI：1.76，8.85），表明女性患高血压的风险几乎增加了四倍，而男性则无显著差异（AOR=1.201，95%CI：0.69，2.07）。