早年暴露于饥荒与成年人血脂异常风险：一项系统综述和Meta分析
Early life exposure to famine and risk of dyslipidemia in adults: a systematic review and Meta-analysis.
作者信息
Arage Getachew, Belachew Tefera, Tamiru Dessalegn, Abate Kalkidan Hassen
机构信息
Department of Nutrition and Dietetics, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia.
出版信息
J Diabetes Metab Disord. 2022 Jun 9;21(2):1809-1817. doi: 10.1007/s40200-022-01062-8. eCollection 2022 Dec.
BACKGROUND
Dyslipidemia is the major contributor to the global disease burden. Earlier epidemiologic research has linked early-life famine exposure to dyslipidemia and altered lipid profiles in adulthood, but a uniform perspective has yet to be established. In response, this systematic review and meta-analysis is aimed to investigate the association of early life famine exposure and dyslipidemia in adults.
METHODS
Scopus, Medline and Google scholar databases were searched for articles published until October 2020. Studies of famine exposure during prenatal and early postnatal life and their association with dyslipidemia and lipid profiles in adults were included. Random effect model in the Meta-analysis and Mantel- Haenszel model was used to calculate odds ratios and their 95% confidence intervals to evaluate the strength of association between famine exposure and dyslipidemia. The lipid profiles of the exposed and non-exposed groups were compared using the standardized mean difference (SMD). Heterogeneity between studies were assessed using I values.
RESULTS
We identified 17 studies for assessing the association between early life famine exposure and risk of dyslipidemia in adults. About 11 studies were included for meta-analysis. Prenatal exposure to famine was associated with increased risk of dyslipidemia [OR = 1.74 (95% CI: 1.31, 2.31)], total cholesterol [SMD = 2.07 (95% CI: 1.40, 2.74)], LDL-cholesterol [SMD = 1.16 (95% CI: 0.25, 0.26)] and decreased HDL-cholesterol [SMD = -0.05 (95% CI: -0.10, -0.01)]. Likewise, famine exposure during early postnatal period was associated with increased risk of total cholesterol [SMD = 0.18 (95% CI: 0.11, 0.25), = 29%] and LDL-cholesterol [SMD = 0.15 (95% CI: 0.07, 0.23), = 61%].
CONCLUSIONS
Famine exposure in early life was found to have an association with increased risk of dyslipidemia and altered lipide profile during adulthood. Our findings highlight the need for promoting better nutrition during pregnancy and infancy to prevent dyslipidemia during adulthood.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-022-01062-8.
背景
血脂异常是全球疾病负担的主要促成因素。早期的流行病学研究已将生命早期接触饥荒与血脂异常以及成年期血脂谱改变联系起来，但尚未形成统一的观点。对此，本系统评价和荟萃分析旨在研究生命早期接触饥荒与成年人血脂异常之间的关联。
方法
检索Scopus、Medline和谷歌学术数据库中截至2020年10月发表的文章。纳入关于产前和产后早期接触饥荒及其与成年人血脂异常和血脂谱关联的研究。荟萃分析中使用随机效应模型和Mantel-Haenszel模型计算比值比及其95%置信区间，以评估接触饥荒与血脂异常之间的关联强度。使用标准化均数差（SMD）比较暴露组和非暴露组的血脂谱。使用I值评估研究之间的异质性。
结果
我们确定了17项评估生命早期接触饥荒与成年人血脂异常风险之间关联的研究。约11项研究纳入荟萃分析。产前接触饥荒与血脂异常风险增加[比值比=1.74（95%置信区间：1.31，2.31）]、总胆固醇[标准化均数差=2.07（95%置信区间：1.40，2.74）]、低密度脂蛋白胆固醇[标准化均数差=1.16（95%置信区间：0.2, 0.26）]以及高密度脂蛋白胆固醇降低[标准化均数差=-0.05（95%置信区间：-0.10，-0.01）]相关。同样，产后早期接触饥荒与总胆固醇风险增加[标准化均数差=0.18（95%置信区间：0.11，0.25），I²=29%]和低密度脂蛋白胆固醇[标准化均数差=0.15（95%置信区间：0.07，0.23），I²=61%]相关。
结论
发现生命早期接触饥荒与成年期血脂异常风险增加和血脂谱改变有关。我们的研究结果强调在孕期和婴儿期促进更好的营养以预防成年期血脂异常的必要性。
补充信息
在线版本包含可在10.1007/s40200-022-01062-8获取的补充材料。
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