胎儿期暴露于饥荒对代谢综合征个体心血管疾病风险的影响。
Effects of fetal famine exposure on the cardiovascular disease risk in the metabolic syndrome individuals.
作者信息
Shu Zhe, Ding Xiong, Yue Qing, Ma XiaoXu, Liu MinHong, Wu YunTao, Yang Peng, Wu Ying, Li Yun, Wu Shouling
机构信息
School of Public Health, North China University of Science and Technology, Tangshan, China.
School of Public Health, Wuhan University, Wuhan, China.
出版信息
Diabetol Metab Syndr. 2022 Nov 17;14(1):173. doi: 10.1186/s13098-022-00948-0.
BACKGROUND
Patients with metabolic syndrome (MS) have a higher incidence of cardiovascular disease (CVD), but the possible mechanisms are not fully understood and further exploration of the possible factors influencing the high incidence of CVD in patients with MS is still needed.
OBJECTIVES
This study aims to examine the association between fetal famine exposure and the risk of CVD in adulthood with MS.
METHODS
Of 13,744 MS patients free of CVD selected from the Kailuan Study in 2006 (referred as the baseline survey) were included in the study. China suffered a severe famine from 1959 to 1962, so the participants born during this period were classified as the uterine famine exposed group. All patients were born between January 1, 1949, and December 31, 1974. Based on the date of birth, all patients were divided into the no-exposed group (born between January 1, 1963, and December 31, 1974), uterine famine exposed group (born between January 1, 1959 and December 31, 1962), and childhood famine exposed group (born between January 1, 1949 and December 31, 1958). After following up to December 31, 2019, the weighted Cox regression analysis model was used to calculate the effect of early life famine exposure in MS individuals on the risk of CVD in adulthood.
RESULTS
During the 12.12 years of follow-up, the incidence of CVD was 5.87%, 10.13%, and 10.90% in the no-exposed group, uterine famine exposed group, and childhood famine exposed group, respectively. Compared with participants in the no-exposed group, the CVD risk and stroke risk increased in participants in the uterine famine exposed group (for CVD, HR: 1.32, 95% CI 1.04-1.67; for stroke, HR:1.37, 95% CI 1.05-1.79), but not in childhood famine exposed group. However, the increased CVD risks were only observed in females or smokers. No increased MI risks were observed for participants in the uterine famine exposed group or childhood famine exposed group.
CONCLUSIONS
Our findings suggested that exposure to famine during uterine life might increase the risk of CVD in adulthood in participants with MS.
背景
代谢综合征（MS）患者心血管疾病（CVD）的发病率较高，但其潜在机制尚未完全明确，仍需进一步探究影响MS患者CVD高发的可能因素。
目的
本研究旨在探讨胎儿期饥荒暴露与成年MS患者CVD风险之间的关联。
方法
选取2006年开滦研究中13744例无CVD的MS患者（作为基线调查）纳入研究。中国在1959年至1962年期间遭受了严重饥荒，因此将在此期间出生的参与者归为子宫内饥荒暴露组。所有患者均出生于1949年1月1日至1974年12月31日之间。根据出生日期，将所有患者分为未暴露组（出生于1963年1月1日至1974年12月31日）、子宫内饥荒暴露组（出生于1959年1月1日至1962年12月31日）和儿童期饥荒暴露组（出生于1949年1月1日至1958年12月31日）。随访至2019年12月31日，采用加权Cox回归分析模型计算MS个体早年饥荒暴露对成年后CVD风险的影响。
结果
在12.12年的随访期间，未暴露组、子宫内饥荒暴露组和儿童期饥荒暴露组的CVD发病率分别为5.87%、10.13%和10.90%。与未暴露组参与者相比，子宫内饥荒暴露组参与者的CVD风险和中风风险增加（CVD的HR：1.32，95%CI 1.04 - 1.67；中风的HR：1.37，95%CI 1.05 - 1.79），但儿童期饥荒暴露组未增加。然而，CVD风险增加仅在女性或吸烟者中观察到。子宫内饥荒暴露组或儿童期饥荒暴露组参与者未观察到心肌梗死风险增加。
结论
我们的研究结果表明，子宫内生活期间暴露于饥荒可能会增加成年MS患者患CVD的风险。
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