In utero exposure to the Great Chinese Famine and risk of intracerebral hemorrhage in midlife

Li, Yun; Li, Yanping; Gurol, M. Edip; Liu, Yesong; Yang, Peng; Shi, Jihong; Zhuang, Sheng; Forman, Michéle R.; Wu, Shouling; Gao, Xiang

doi:10.1212/wnl.0000000000009407

Cited by 28 publications

(27 citation statements)

References 37 publications

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“…Provinces that had at least 50% excess mortality, which was calculated based on the highest mortality rate recorded during the famine for that province and the average mortality rate before the famine, were classified as “severely affected” by the famine, while the provinces with <50% excess mortality were classified as “less severely affected” (7,15). This method is consistent with previous studies of the Great Chinese Famine (7,13).…”

Section: Participants and Methodssupporting

confidence: 91%

In Utero and Early Life Exposure to the Great Chinese Famine and Risk of Rheumatoid Arthritis in Adulthood

VanEvery

Yang

Olsen

et al. 2021

Arthritis & Rheumatology

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Objective. To investigate whether early life exposure to the Great Chinese Famine of 1959−1961 is associated with the risk of RA development in adulthood. Methods. This study included 101,510 participants who were enrolled in the Kailuan Study in 2006. RA cases were confirmed by medical record review. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) for RA according to famine exposure status (exposed in utero or between ages 0 and 3 years, between ages 3 and 6 years, or at age 6 years or older), in comparison to participants born after 1961 who were not exposed to famine. Results. During 12 years of follow-up (2006−2018), we identified 187 RA cases. Individuals exposed to famine in utero or between ages 0 and 3 years had a higher prevalence of RA relative to other groups (0.2−0.35% versus 0.08−0.20%). After adjustment for potential confounders, the OR for RA was 2.95 (95% CI 1.55−5.59) for individuals exposed in utero, 4.53 (95% CI 2.72−7.54) for those exposed between ages 0 and 3 years, 2.55 (95% CI 1.43−4.57) for those exposed between ages 3 and 6 years, and 2.72 (95% CI 1.70−4.36) for those exposed at age 6 years or older versus individuals born after 1961. Similar associations with the risk of RA were observed for men and women when subjects were stratified by sex (P for interaction = 0.89). Conclusion. Individuals exposed to famine in utero or in early childhood (between ages 0 and 3 years) were more likely to develop RA in adulthood, highlighting the importance of early life as a vulnerable developmental period. PARTICIPANTS AND METHODS Study population. The Kailuan Study is an ongoing prospective cohort study designed to investigate risk factors for CVD. After recruitment in 2006, 101,510 participants between ages 18

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Section: Participants and Methodssupporting

confidence: 91%

In Utero and Early Life Exposure to the Great Chinese Famine and Risk of Rheumatoid Arthritis in Adulthood

VanEvery

Yang

Olsen

et al. 2021

Arthritis & Rheumatology

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“…In total, 101,510 participants (between 18 and 98 years old; 81,110 men and 20,400 women) were enrolled in the study at baseline in 2006. Between June 2006 and October 2007, each participant completed a baseline survey, referred to here as the “2006 survey”, that collected information on demographics, lifestyle factors, medical conditions, and medication usage [ 17 , 18 , 19 ]. After the baseline visit, the survey was re-administered every two years.…”

Section: Methodsmentioning

confidence: 99%

Alcohol Consumption and Risk of Rheumatoid Arthritis among Chinese Adults: A Prospective Study

et al. 2021

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Alcohol consumption may be associated with the risk of rheumatoid arthritis (RA), but potential sex-related differences in this association have not been explored. Thus, we utilized 87,118 participants in the Kailuan Study, a prospective cohort initiated in 2006 to study the risk factors of cardiovascular disease in a Chinese population. We included those that did not have RA at baseline (2006), and performed cox proportional hazard modeling to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of RA according to the levels of alcohol consumption (never or past, light or moderate (<1 serving/day for women, <2 servings/day for men), and heavy (>1 serving/day for women, >2 servings/day for men), adjusting for age, sex, body mass index, and smoking. Diagnoses of RA were confirmed via medical record review by rheumatologists. From 2006 to 2018, we identified 87 incident RA cases. After adjusting for potential confounders, the HR of RA was 1.26 (95% CI: 0.62, 2.56) for participants with light or moderate alcohol consumption and 1.98 (95% CI: 0.93, 4.22) for participants with heavy alcohol consumption) versus non-drinkers. The HR of each 10 g increase in alcohol consumption was 1.11 (95% CI: 0.98, 1.26) (p-trend = 0.09). A significant association between alcohol consumption and RA risk was observed in women, but not in men (p for interaction = 0.06). Among women, each 10 g increase in alcohol consumption was significantly associated with a high risk of RA (HR: 1.56; 95% CI: 1.06, 2.29). In contrast, each 10 g increase in alcohol consumption was not significantly associated with the risk of RA in men (HR: 1.10; 95% CI: 0.97, 1.25). Excluding past drinkers generated similar results. In this prospective Chinese cohort, increasing alcohol consumption was associated with an elevated risk of RA among women, but not in men. These findings highlight the importance of incorporating analysis of sex differences into future studies of alcohol consumption and RA risk.

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“…Fetal programming also affects the brain and cerebrovascular circulation resulting in altered brain structure with increased risk for learning disabilities and cognitive dysfunction [ 4 , 18 ]. In addition, fetal programming also appears to increase the risk for cerebrovascular disease in offspring from food-restricted mothers [ 3 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal Undernutrition Modulates Neonatal Rat Cerebrovascular Structure, Function, and Vulnerability to Mild Hypoxic-Ischemic Injury via Corticosteroid-Dependent and -Independent Mechanisms

Franco

Durrant

Doan

et al. 2021

IJMS

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The present study explored the hypothesis that an adverse intrauterine environment caused by maternal undernutrition (MUN) acted through corticosteroid-dependent and -independent mechanisms to program lasting functional changes in the neonatal cerebrovasculature and vulnerability to mild hypoxic-ischemic (HI) injury. From day 10 of gestation until term, MUN and MUN-metyrapone (MUN-MET) group rats consumed a diet restricted to 50% of calories consumed by a pair-fed control; and on gestational day 11 through term, MUN-MET groups received drinking water containing MET (0.5 mg/mL), a corticosteroid synthesis inhibitor. P9/P10 pups underwent unilateral carotid ligation followed 24 h later by 1.5 h exposure to 8% oxygen (HI treatment). An ELISA quantified MUN-, MET-, and HI-induced changes in circulating levels of corticosterone. In P11/P12 pups, MUN programming promoted contractile differentiation in cerebrovascular smooth muscle as determined by confocal microscopy, modulated calcium-dependent contractility as revealed by cerebral artery myography, enhanced vasogenic edema formation as indicated by T2 MRI, and worsened neurobehavior MUN unmasked HI-induced improvements in open-field locomotion and in edema resolution, alterations in calcium-dependent contractility and promotion of contractile differentiation. Overall, MUN imposed multiple interdependent effects on cerebrovascular smooth muscle differentiation, contractility, edema formation, flow-metabolism coupling and neurobehavior through pathways that both required, and were independent of, gestational corticosteroids. In light of growing global patterns of food insecurity, the present study emphasizes that infants born from undernourished mothers may experience greater risk for developing neonatal cerebral edema and sensorimotor impairments possibly through programmed changes in neonatal cerebrovascular function.

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In utero exposure to the Great Chinese Famine and risk of intracerebral hemorrhage in midlife

Cited by 28 publications

References 37 publications

In Utero and Early Life Exposure to the Great Chinese Famine and Risk of Rheumatoid Arthritis in Adulthood

In Utero and Early Life Exposure to the Great Chinese Famine and Risk of Rheumatoid Arthritis in Adulthood

Alcohol Consumption and Risk of Rheumatoid Arthritis among Chinese Adults: A Prospective Study

Maternal Undernutrition Modulates Neonatal Rat Cerebrovascular Structure, Function, and Vulnerability to Mild Hypoxic-Ischemic Injury via Corticosteroid-Dependent and -Independent Mechanisms

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