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Early-Life Famine Exposure and Risk of Cardiovascular Diseases in Later Life: Findings From the REACTION Study.

State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China. Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China. The First Hospital of Lanzhou University Lanzhou China. Zhejiang Provincial Center for Disease Control and Prevention Hangzhou China. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China. Affiliated Hospital of Guiyang Medical College Guiyang China. The Affiliated Hospital of Luzhou Medical College Luzhou China. Fujian Provincial Hospital Fujian Medical University Fuzhou China. Dalian Municipal Central Hospital Dalian China. The First Hospital of Jilin University Changchun China. The First Affiliated Hospital of Wenzhou Medical University Wenzhou China. The First Affiliated Hospital of Guangxi Medical University Nanning China. Qilu Hospital of Shandong University Jinan China. Jiangxi Provincial People's Hospital Affiliated to Nanchang University Nanchang China. The Second Affiliated Hospital of Harbin Medical University Harbin China. Central Hospital of Shanghai Jiading District Shanghai China. Jiangsu Province Hospital on Integration of Chinese and Western Medicine Nanjing China. The First Affiliated Hospital of Anhui Medical University Hefei China. Karamay Municipal People's Hospital Xinjiang China. The First Affiliated Hospital of Nanjing Medical University Nanjing China. The First Affiliated Hospital of Chongqing Medical University Chongqing China. Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China. Shandong Provincial Hospital affiliated to Shandong University Jinan China. Chinese People's Liberation Army General Hospital Beijing China. Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston TX. The First Affiliated Hospital of Zhengzhou University Zhengzhou China. Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China.

Journal of the American Heart Association. 2020;(7):e014175
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Abstract

Background Previous studies reported that early-life exposure to undernutrition is associated with the risk of diabetes mellitus and metabolic syndrome in adulthood, but the association with risk of cardiovascular disease (CVD) later in life remains unclear. The current study aimed to investigate whether exposure to Chinese famine in early life is associated with risk of CVD. Methods and Results We used data from REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study), which recruited a total of 259 657 community-dwelling adults aged 40 years or older from 25 centers across mainland China between 2011 and 2012. Compared with the nonexposed participants, those who had been exposed to famine in early life had a significantly increased risk of total CVD, myocardial infarction, stroke, and coronary heart disease. In the multivariable-adjusted logistic regression model, the odds ratios (95% CI) for total CVD, myocardial infarction, stroke, and coronary heart disease in fetal famine exposure were 1.35 (1.20-1.52), 1.59 (1.08-2.35), 1.40 (1.11-1.78), and 1.44 (1.26-1.65), respectively; those odds ratios in childhood famine exposure were 1.59 (1.40-1.81), 2.20 (1.52-3.20), 1.82 (1.45-2.28), and 1.80 (1.56-2.09), respectively; and those in adolescent famine exposure were 1.52 (1.27-1.81), 2.07 (1.28-3.35), 1.92 (1.42-2.58), and 1.83 (1.50-2.24), respectively. The main finding of our study is that, compared with those who lived in the less severely affected famine area, individuals in the severely affected famine area had significantly increased risk of total CVD in all 3 exposed groups. Conclusions Early-life exposure to undernutrition is associated with significantly increased risk of CVD in later life, especially among those who were in the severely affected famine area.

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