Early-Life Exposure to Famine and Risk of Metabolic Associated Fatty Liver Disease in Chinese Adults

Abstract

Background: Early-life exposure to the Chinese famine has been related to the risk of obesity, type 2 diabetes, and nonalcoholic fatty liver disease later in life. Nevertheless, the long-term impact of famine exposure on metabolic associated fatty liver disease (MAFLD), a recently proposed term to describe liver disease associated with known metabolic dysfunction, remains unknown. The aim of our study was to explore the relationship between early famine exposure and MAFLD in adulthood. Methods: A total of 26,821 participants (10,994 men, 15,827 women) were recruited from a cohort study of Chinese adults in Shanghai. We categorized participants into four famine exposure subgroups based on the birth year as nonexposed (1963–1967), fetal-exposed (1959–1962), childhood-exposed (1949–1958), and adolescence-exposed (1941–1948). MAFLD was defined as liver steatosis detected by ultrasound plus one of the following three criteria: overweight/obesity, type 2 diabetes, or evidence of metabolic dysregulation. Multivariable logistic regression models were performed to examine the association between famine exposure and MAFLD. Results: The mean ± standard deviation age of the participants was 60.8 ± 6.8 years. The age-adjusted prevalence of MAFLD was 38.3, 40.8, 40.1, and 36.5% for the nonexposed, fetal-exposed, childhood-exposed, and adolescence-exposed subgroups, respectively. Compared with nonexposed participants, fetal-exposed participants showed an increased risk of adulthood MAFLD (OR = 1.10, 95% CI 1.00–1.21). The significant association between fetal famine exposure and MAFLD was observed in women (OR = 1.22, 95% CI 1.08–1.37), but not in men (OR = 0.88, 95% CI 0.75–1.03). In age-balanced analyses combining pre-famine and post-famine births as the reference, women exposed to famine in the fetal stage still had an increased risk of MAFLD (OR = 1.15, 95% CI 1.05–1.26). Conclusions: Prenatal exposure to famine showed a sex-specific association with the risk of MAFLD in adulthood.

Prenatal ozone exposure programs a sexually dimorphic susceptibility to high‐fat diet in adolescent Long Evans rats

“…Interestingly, a similar metabolic sensitivity has also been described in adults exposed to famine in early life, with females having increased rates of NAFLD compared to males. 54,55 However, it is worth noting that similar conditions have also been observed in males exposed to prenatal undernutrition, 56 indicating that sexual dimorphism in developmental reprogramming may be highly specific to the prenatal stressor.…”

Association Between NLR and NAFLD in Adults Exposed to Famine in Early Life

“…[12][13][14] Qi 15 suggested that individuals who exposed to famine in early life, have a higher risk of developing NAFLD than those who unexposed to famine. Liu et al 16 also found that adults born during a famine period had a higher prevalence of NAFLD. However, prior studies have not matched famine and control cohorts for age, which is an important factor of liver diseases and therefore an important confounder that should be accounted for.…”

Maternal obesity induced metabolic disorders in offspring and myeloid reprogramming by epigenetic regulation

“…Maternal nutritional status has been linked to an increased risk of future disease in offspring. In a cohort study on Chinese adults, it was found that fetal exposure to maternal famine was associated with an increased risk of adulthood MAFLD (metabolic-associated fatty liver disease), especially in women ( 8 ). Additionally, prenatal exposure to maternal famine during early gestation was associated with a higher prevalence of coronary heart disease than non-exposed offspring ( 9 ).…”