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

Yunhan Xu; Qian Yi; Shiyi Shan; Jiali Zhou; Shuting Li; Leying Hou; Xinxin Ye; Jiayao Ying; Peige Song; Lin An

doi:10.3389/fendo.2022.975824

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

Front Endocrinol (Lausanne). 2022 Sep 20:13:975824. doi: 10.3389/fendo.2022.975824. eCollection 2022.

Authors

Yunhan Xu^{1

2}, Qian Yi², Shiyi Shan², Jiali Zhou², Shuting Li², Leying Hou², Xinxin Ye^{2

3}, Jiayao Ying², Peige Song^{2

4}, Lin An¹

Affiliations

¹ Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
² School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China.
³ Department of Sport and Exercise Science, College of Education, Zhejiang University, Hangzhou, China.
⁴ Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Abstract

Objective: To assess the association between early life exposure to famine and the risk of metabolic obesity phenotypes among adults in middle age.

Methods: The 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.

Results: Compared 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.

Conclusion: Exposure 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.

Keywords: CHARLS; early childhood; famine; fetal; metabolic obesity phenotype.

MeSH terms

Child, Preschool
China / epidemiology
Famine*
Female
Humans
Longitudinal Studies
Male
Middle Aged
Obesity / epidemiology
Obesity / etiology
Overweight
Phenotype
Retirement
Starvation* / epidemiology