Kannisto V, Christensen K, Vaupel J W
Odense University Medical School, Denmark.
Am J Epidemiol. 1997 Jun 1;145(11):987-94. doi: 10.1093/oxfordjournals.aje.a009067.
Nutrition early in life may influence adult mortality. The fetal-origins hypothesis suggests that nourishment before birth and during the individual's infancy programs the development of risk factors for several important diseases of middle and old age. The present study was designed to evaluate the impact of extreme nutritional deprivation in utero and during infancy and early childhood on mortality in later life. The authors analyzed the survival of the cohorts born in Finland during the severe 1866-1868 famine and during the 5 years immediately preceding and 5 years immediately following the famine. The study included 331,932 individuals born prior to the famine, 161,744 born during the famine, and 323,321 born after the famine. The authors assessed survival by cohorts from birth to age 17 years and from age 17 to 40, 60, and 80 years, as well as average length of life after age 80 years. Survival from birth to age 17 years was significantly lower in cohorts born before and during the famine than in the cohorts born after the famine (males, 0.566 vs. 0.671, a difference of 0.105 (95% confidence interval (CI) 0.102-0.108); females, 0.593 vs. 0.692, a difference of 0.099 (95% CI 0.096-0.102)). At subsequent ages, including old age, mortality was practically identical in the famine-born cohorts and in the five cohorts born before and after the crisis. For both males and females, survival from 17 to 80 years and mean remaining lifetime at age 80 years were very similar across the 13 cohorts studied. These findings suggest that, although cohorts subjected to prolonged and extreme nutritional deprivation in utero and during infancy and early childhood suffer an immediate rise in mortality, after the crisis has passed, they carry no aftereffects that influence their survival in later life.
生命早期的营养状况可能会影响成人死亡率。胎儿起源假说认为，出生前及婴儿期的营养状况会为个体成年后的一些重要中老年疾病的危险因素发展设定程序。本研究旨在评估子宫内以及婴儿期和幼儿期的极端营养剥夺对晚年死亡率的影响。作者分析了1866 - 1868年芬兰严重饥荒期间、饥荒前5年及饥荒后5年出生队列的生存情况。该研究纳入了饥荒前出生的331,932人、饥荒期间出生的161,744人以及饥荒后出生的323,321人。作者评估了各队列从出生到17岁、从17岁到40岁、60岁和80岁的生存率，以及80岁以后的平均寿命。饥荒前及饥荒期间出生的队列从出生到17岁的生存率显著低于饥荒后出生的队列（男性：0.566对0.671，差异为0.105（95%置信区间（CI）0.102 - 0.108）；女性：0.593对0.692，差异为0.099（95%CI 0.096 - 0.102））。在随后的年龄段，包括老年，饥荒出生队列与危机前后出生的五个队列的死亡率几乎相同。对于男性和女性而言，在研究的13个队列中，从17岁到80岁的生存率以及80岁时的平均剩余寿命非常相似。这些发现表明，尽管在子宫内以及婴儿期和幼儿期遭受长期极端营养剥夺的队列死亡率会立即上升，但危机过后，他们不会有影响其晚年生存的后遗症。
