Department of Endocrinology and Metabolism, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
Sichuan Clinical Research Center for Nephropathy, Luzhou, China.
Nutr Diabetes. 2024 Oct 9;14(1):84. doi: 10.1038/s41387-024-00342-x.
Malnutrition early in life increases the later-life risk of noncommunicable diseases, and previous epidemiologic studies have found a link between famine and renal impairment, but no consensus has been reached. This meta-analysis and systematic review were conducted to assess the correlation between early-life famine exposure and the risk of developing renal impairment. Search in Embase, Scopus, Web of Science, PubMed, and Cochrane using keywords that report the correlation between early famine exposure and renal function indicators. RevMan and Stata software were used for data analysis. This meta-analysis contained twelve observational studies. The findings demonstrated a link between prenatal famine exposure and a higher risk of developing chronic kidney disease (CKD) (odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.25, 2.39), a decreased estimated glomerular filtration rate (eGFR) (mean difference (MD) = -10.05, 95% CI: -11.64, -8.46), and increased serum creatinine (Scr) (MD = 0.02, 95% CI: 0.01, 0.03) compared to unexposed individuals. Famine exposure in childhood was associated with decreased eGFR (MD = -9.43, 95% CI: -12.01, -6.84) and increased Scr (MD = 0.03, 95% CI: 0.01, 0.04), but not with CKD (OR = 0.980, 95% CI: 0.53, 1.81). Famine exposure in adolescence and adulthood was associated with decreased eGFR (MD = -20.73, 95% CI: -22.40, -19.06). Evidence certainty was deemed to be of low or extremely low quality. Famine exposure early in life could pose a greater risk of developing renal impairment in adulthood, but this outcome may be driven by uncontrolled age differences between famine-births and post-famine-births (unexposed).
生命早期营养不良会增加日后患非传染性疾病的风险，先前的流行病学研究已经发现饥荒与肾功能损害之间存在关联，但尚未达成共识。本荟萃分析和系统评价旨在评估生命早期饥荒暴露与发生肾功能损害风险之间的相关性。使用报告早期饥荒暴露与肾功能指标相关性的关键词，在 Embase、Scopus、Web of Science、PubMed 和 Cochrane 中进行检索。使用 RevMan 和 Stata 软件进行数据分析。本荟萃分析包含 12 项观察性研究。研究结果表明，产前饥荒暴露与慢性肾脏病（CKD）风险增加（比值比（OR）=1.73，95%置信区间（CI）：1.25，2.39）、估算肾小球滤过率（eGFR）降低（平均差异（MD）=-10.05，95%CI：-11.64，-8.46）和血清肌酐（Scr）升高（MD=0.02，95%CI：0.01，0.03）有关，与未暴露个体相比。儿童期饥荒暴露与 eGFR 降低（MD=-9.43，95%CI：-12.01，-6.84）和 Scr 升高（MD=0.03，95%CI：0.01，0.04）有关，但与 CKD 无关（OR=0.980，95%CI：0.53，1.81）。青春期和成年期的饥荒暴露与 eGFR 降低（MD=-20.73，95%CI：-22.40，-19.06）有关。证据质量被认为是低或极低质量。生命早期的饥荒暴露可能会增加成年后患肾功能损害的风险，但这一结果可能是由饥荒出生和饥荒后出生（未暴露）之间无法控制的年龄差异驱动的。
