Association between exposure to the Chinese famine during infancy and the risk of self-reported chronic lung diseases in adulthood: a cross-sectional study

Wang, Zhenghe; Zou, Zhiyong; Yang, Zhongping; Dong, Yanhui; Ma, Jun

doi:10.1136/bmjopen-2016-015476

Cited by 19 publications

(20 citation statements)

References 26 publications

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“…The association between the famine exposure in fetal period and diabetes risk seems to be stronger among males than females in our study. Similar sex disparity was also observed in our previous study, which found that males were associated with the higher risks of early life famine exposure related chronic lung diseases [ 33 ]. We speculate that the sex difference might be linked with the sensitivity response to famine exposure between sexes.…”

Section: Discussionsupporting

confidence: 88%

The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study

et al. 2018

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BackgroundThe associations of famine exposure with diabetes risk in adulthood are still unclear. This study aimed to explore the association between famine exposure in early life and risk of diabetes in adulthood.MethodsA total of 4138 subjects were selected from the data of the China Health and Retirement Longitudinal Study (CHARLS) 2011–2012. Diabetes was diagnosed as fasting plasma glucose (FPG) ≥7.0 mmol/L, glycated haemoglobin (HbA1C) > 6.5%, or self-reported diabetes. Birthdates of subjects were used to categorize famine exposure groups. The association of fetal-stage famine exposure with diabetes risk in adults was assessed using logistics regression model.ResultsThe prevalence of diabetes in the non-exposed, fetal-stage exposed, infant-stage exposed, and preschool-stage exposed groups were 9.0, 13.6, 12.7 and 10.8%, respectively. Compared with the age-balanced control group, the fetal-stage exposed group was associated with the elevated risk of diabetes in later life after adjusting for covariates (OR = 1.37; 95%CI: 1.09–1.72; P = 0.008). Stratified analysis showed that the association between prenatal famine exposure and diabetes risk in adulthood was comparable between severely affected areas and less severely affected areas (P for interaction =0.153).ConclusionsFamine exposure in fetal stages was associated with the elevated diabetes risk in adults, which could be the critical periods for relative intervention.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6134-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 88%

The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study

et al. 2018

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“…The Chinese Great Famine between 1959 and 1961 caused millions of excess deaths 3. A few studies in recent years have explored the potential impacts of this famine on adult health, mostly on metabolic disorders and mental illness, and only a few on cancer and respiratory disease 4–6. Most of the studies were cross-sectional, in which survival bias is of particular relevance, and the prevalent cases that survive to be in the study may offer a distorted frequency of famine exposure.…”

Section: Introductionmentioning

confidence: 99%

Early famine exposure and adult disease risk based on a 10-year prospective study of Chinese adults

Meng

Guo

et al. 2019

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ObjectiveTo comprehensively examine the potential impacts of prenatal experience of the Chinese Great Famine on chronic disease risks in the middle age.MethodsThis study included 92 284 participants aged 39–51 years from China Kadoorie Biobank born around the famine period and without major chronic diseases at baseline. We categorised participants into non-famine births (born between 1 October 1956 and 30 September 1958, and 1 October 1962 and 30 September 1964) and famine births (born between 1 October 1959 and 30 September 1961). The outcomes were incident cardiovascular disease, cancer and respiratory system disease. Cox regression was used to estimate adjusted HR and 95% CI for famine exposure. Subgroup analyses were performed according to baseline characteristics.ResultsDuring a median 10.1 years of follow-up, we identified 4626 incident ischaemic heart disease (IHD) cases, 7332 cerebrovascular disease cases, 3111 cancer cases and 16 081 respiratory system disease cases. In the whole population, prenatal famine exposure was not statistically associated with the risks of developing any chronic diseases in adulthood. However, for urban participants, compared with non-famine births, famine births had a higher risk of cerebrovascular disease (HR 1.18; 95% CI 1.09 to 1.28); such association was not shown for rural participants (p for interaction <0.001). Also, we observed the associations of prenatal famine exposure with IHD (HR 1.15; 95% CI 1.05 to 1.26) and cerebrovascular disease (HR 1.13; 95% CI 1.05 to 1.21) in participants with lower physical activity level, but not in those with higher ones (all p for interaction=0.003).ConclusionOur findings indicate that prenatal exposure to the Chinese famine might be associated with an increased cardiovascular risk and such risk may be modified by adult lifestyle.

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“…Excess mortality was the change in mortality rate from the average in 1956–1958 to the highest value among the period of 1959–1962 and was used to reflect the severity of famine exposure in the current study, which is consistent with previous studies 14 24. The regions with excess mortality of 100% were used to differentiate the severely affected areas from the mildly affected areas in this study 25…”

Section: Methodsmentioning

confidence: 65%

Association between early-life exposure to the Great Chinese Famine and poor physical function later in life: a cross-sectional study

Tao

Dai

et al. 2019

BMJ Open

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ObjectivesThis study aimed to evaluate the association between early-life exposure to the Great Chinese Famine (1959–1961) and the prevalence of poor physical function in midlife.DesignA population-based historical prospective study was performed as part of a wider cross-sectional survey. Exposure to famine was defined by birthdate, and participants were divided into non-exposed group, fetal-exposed group and infant-exposed group.Setting and participantsA total of 3595 subjects were enrolled into the study from the China Health and Retirement Longitudinal Study (CHARLS) 2015 based on random selection of households that had at least one member aged 45 years old and older in 28 provinces of mainland China.Main outcome measuresPhysical function status was assessed by a six-item self-report on the Barthel scale which rated basic activities of daily living (BADL).Results743 (20.7%) out of all participants were exposed to the Great Chinese Famine in their fetal periods, while 1550 (43.1%) participants were exposed at the age of an infant. The prevalence of poor physical function in the non-exposed group, fetal period-exposed group and infant period-exposed group were 12.3%, 15.5% and 17.0%, respectively. Among males, after stratification by gender and severity of famine, the prevalence of poor physical function in the fetal period was significantly higher (OR 2.40, 95% CI 1.18 to 4.89, p=0.015) than the non-exposed group in severely affected areas, even after adjusting for the number of chronic diseases, place of residence, smoking and alcohol drinking habits, marital status, educational level and body mass index. A similar connection between prenatal and early postnatal exposure to the Great Chinese Famine and the prevalence of poor physical function in midlife, however, was not observed from female adults.ConclusionsMales who were exposed to the Great Chinese Famine (1959–1961) present considerably decreased physical function in their later life.

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Association between exposure to the Chinese famine during infancy and the risk of self-reported chronic lung diseases in adulthood: a cross-sectional study

Cited by 19 publications

References 26 publications

The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study

The association between fetal-stage exposure to the China famine and risk of diabetes mellitus in adulthood: results from the China health and retirement longitudinal study

Early famine exposure and adult disease risk based on a 10-year prospective study of Chinese adults

Association between early-life exposure to the Great Chinese Famine and poor physical function later in life: a cross-sectional study

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