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社会经济地位对生命早期暴露于饥荒与女性骨质疏松症之间关联的修饰作用。

Effect modification of socioeconomic status on the association of exposure to famine in early life with osteoporosis in women.

机构信息

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.

Orthopedics Department of Wenzhou Central Hospital, Wenzhou, China.

出版信息

J Hum Nutr Diet. 2023 Aug;36(4):1349-1358. doi: 10.1111/jhn.13164. Epub 2023 Apr 9.

Abstract

BACKGROUND

The present study aimed to explore the effect of modification of socioeconomic status (SES) on the association between famine exposure in early life and osteoporosis in adulthood via the baseline data from the Henan Rural cohort study.

METHODS

A total of 2669 exposed to famine participants were selected from the Henan Rural cohort, and the questionnaires, physical examination and bone mineral density measurement were completed. Specific birth years were used to define five groups: the fetal exposed group, early-childhood exposed group, mid-childhood exposed group, late-childhood exposed group and unexposed group. And the age-matched control group was a combination of the unexposed group and late-childhood exposed group. Multivariable logistic regression models were utilised to analyse the association of famine exposure in early life with osteoporosis in adulthood.

RESULTS

The prevalence rates of osteoporosis of participants exposed to famine during the fetal period, early-childhood, mid-childhood and the age-matched group were 21.67%, 25.76%, 23.90% and 18.14%, respectively. The adjusted odds ratios (95% confidence interval) of participants suffering from famine during the fetal period, early-childhood and mid-childhood versus age-matched group were 1.19 (0.82-1.73), 1.40 (1.04-1.88) and 1.57 (1.16-2.13), respectively. The female participants yielded consistent results. The risk of osteoporosis was higher in more severe famine eara. Moreover, an attenuated effect of early life famine exposure on osteoporosis was observed in female participants with high SES.

CONCLUSIONS

Exposure to famine in early life showed a sex-specific association with an increased risk of osteoporosis in adulthood and the severity of famine may exacerbate this association. In addition, the risk could be modified by SES.

摘要

背景

本研究旨在通过河南农村队列研究的基线数据,探讨通过修正社会经济地位(SES)对生命早期饥荒暴露与成年后骨质疏松症之间关联的影响。

方法

从河南农村队列中选取 2669 名暴露于饥荒的参与者,完成问卷调查、体格检查和骨密度测量。特定的出生年份用于定义五个组别:胎儿期暴露组、幼儿期暴露组、儿童中期暴露组、儿童后期暴露组和未暴露组。年龄匹配的对照组由未暴露组和儿童后期暴露组组成。采用多变量逻辑回归模型分析生命早期饥荒暴露与成年后骨质疏松症的关系。

结果

暴露于胎儿期、幼儿期、儿童中期和年龄匹配组的参与者骨质疏松症的患病率分别为 21.67%、25.76%、23.90%和 18.14%。与年龄匹配组相比,胎儿期、幼儿期和儿童中期经历饥荒的参与者患病的调整优势比(95%置信区间)分别为 1.19(0.82-1.73)、1.40(1.04-1.88)和 1.57(1.16-2.13)。女性参与者得到了一致的结果。饥荒严重程度越高,骨质疏松症的风险越高。此外,在 SES 较高的女性参与者中,生命早期饥荒暴露对骨质疏松症的影响呈减弱趋势。

结论

生命早期的饥荒暴露与成年后骨质疏松症的风险呈性别特异性关联,且饥荒的严重程度可能会加剧这种关联。此外,风险可以通过 SES 进行修正。

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