Chinese famine exposure in early life and metabolic obesity phenotype in middle age: Results from the China health and retirement longitudinal study

Abstract

ObjectiveTo assess the association between early life exposure to famine and the risk of metabolic obesity phenotypes among adults in middle age.MethodsThe study selected two comparison groups. Comparison A consisted of a non-exposed group born between 1963-1965 from the China Health and Retirement Longitudinal Study (CHARLS) 2015 wave (N=862) and a fetal-exposed group born between 1959-1961 from the 2011 wave (N=507). Comparison B consisted of an early childhood-exposed group born between 1955-1957 from the 2011 wave (N=830) and a fetal-exposed group born between 1959-1961 from the 2015 wave (N=552). Multivariable logistic regressions were conducted to explore the associations between different periods of famine exposure and obesity, metabolic health status, and metabolic obesity phenotypes, with stratification by sex.ResultsCompared with the non-exposed group, participants exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.78, 95%CI: 0.63-0.97) and a higher risk of metabolically unhealthy status (OR: 1.73, 95%CI: 1.34-2.23) and metabolically unhealthy non-obesity (MUNO) (OR: 2.12, 95%CI: 1.46-3.08) at the age of 50-52 years. In the sex-stratified analysis, males exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.59, 95%CI: 0.43-0.80) and metabolically healthy obesity (MHO) (OR: 0.56, 95%CI: 0.37-0.85), while such associations were not found in females. Compared with the early childhood exposure group, participants in the fetal exposure group had a significantly lower risk of metabolic unhealthy status (OR: 0.65, 95%CI: 0.51-0.85) and MUNO (OR: 0.50, 95%CI: 0.35-0.72). Those associations were observed in both males and females.ConclusionExposure to famine in early life increased the risk of metabolically unhealthy status in adulthood. Different metabolic subtypes should be identified at an early stage and followed by classification, intervention, and treatment.

Associations of concurrent early‐life famine exposure and adulthood obesity with type 2 diabetes mellitus in middle‐aged Chinese

“…The Great Famine spread throughout the mainland of China from 1959 to 1961 9,10 . The participants were categorized into three groups according to their birthdates: (a) the nonexposed group (born between January 1, 1963 and December 31, 1965); (b) the fetal‐exposed group (born between January 1, 1959 and December 31, 1961); and (c) the early childhood‐exposed group (born between January 1, 1955 and December 31, 1957) 11,12 . Consistent with previous studies, we employed the excess death rate (EDR) to assess famine severity at the province level 13,14 .…”

“… 9 , 10 The participants were categorized into three groups according to their birthdates: (a) the nonexposed group (born between January 1, 1963 and December 31, 1965); (b) the fetal‐exposed group (born between January 1, 1959 and December 31, 1961); and (c) the early childhood‐exposed group (born between January 1, 1955 and December 31, 1957). 11 , 12 Consistent with previous studies, we employed the excess death rate (EDR) to assess famine severity at the province level. 13 , 14 The EDR was calculated as the percentage change between the average death rate for the 3 years preceding the famine (1956–1958) and the highest death rate during the famine (1959–1961).…”

Association between metabolic obesity phenotype, transition of metabolic phenotypes and the risk of hyperuricemia in Chinese adults: A cohort study

“…The CHARLS study was approved by the Biomedical Ethics Committee of Peking University (IRB00001052-11015), and all subjects participating in the study signed the informed consent . [ 7 ]…”

“…The CHARLS study was approved by the Biomedical Ethics Committee of Peking University (IRB00001052-11015), and all subjects participating in the study signed the informed consent . [7] This study selected 2011 as the baseline and 6059 adult residents with complete blood uric acid measurement data and demographic data in 2 follow-up surveys in 2015.…”

“…[ 4 , 5 ] However, the MHOWO phenotype is not a stable state, [ 6 ] and studies have shown that 33% to 52% of MHOWO patients will transform into a metabolically unhealthy phenotype. [ 7 , 8 ] However, there is no evidence on how MHOWO transitions in the Chinese population and its association with the risk of hyperuricemia. It remains unclear how metabolic factors change over time across and how such dynamic metabolic transitions affects hyperuricemia risk among Chinese adults.…”