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Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study

OBJECTIVE: This study aimed to explore the association between famine exposure in early life and the odds of rheumatoid arthritis (RA) in adulthood. DESIGN: A population-based retrospective cohort study. SETTING: China. PARTICIPANTS: A total of 111 706 participants (1775 with RA) born from 1956 to 1...

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Autores principales: Liu, Chunyu, Meng, Xiangrui, Zhang, Hao, Yang, Fan, Pan, Xiaoyu, Tang, Kun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258564/
https://www.ncbi.nlm.nih.gov/pubmed/34226211
http://dx.doi.org/10.1136/bmjopen-2020-043416
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author Liu, Chunyu
Meng, Xiangrui
Zhang, Hao
Yang, Fan
Pan, Xiaoyu
Tang, Kun
author_facet Liu, Chunyu
Meng, Xiangrui
Zhang, Hao
Yang, Fan
Pan, Xiaoyu
Tang, Kun
author_sort Liu, Chunyu
collection PubMed
description OBJECTIVE: This study aimed to explore the association between famine exposure in early life and the odds of rheumatoid arthritis (RA) in adulthood. DESIGN: A population-based retrospective cohort study. SETTING: China. PARTICIPANTS: A total of 111 706 participants (1775 with RA) born from 1956 to 1964 were selected from the baseline survey of a large cohort in China. PRIMARY AND SECONDARY OUTCOME MEASURES: Four famine exposure groups were generated based on dates of birth, namely prenatal-exposed, infant-exposed, preschool-exposed and non-exposed groups. Logistic regressions were used to explore the association between famine exposure and self-reported RA in adulthood, adjusting for sex, region, monthly income, highest education, alcohol consumption, tobacco use, body mass index (BMI) and metabolic equivalent tasks. Analyses were also performed with stratification for sex (female or male), residing region (urban or rural), famine severity (severe or non-severe) and BMI (≥24 or <24). RESULTS: The study included 1775 (1.59%) RA cases and 109 931 (98.41%) non-RA controls. Among them, 22 413 (20.06%) were prenatal-exposed, 14 899 (13.34%) were infant-exposed and 34 356 (30.76%) were preschool-exposed. Prenatal exposure to famine was not associated with onset of RA in adulthood. Infant-exposed group and preschool-exposed group had significantly elevated odds of getting RA compared with non-exposed group (infant-exposed: OR=1.44, 95% CI 1.24 to 1.67; preschool-exposed: OR=1.38, 95% CI 1.22 to 1.57, p<0.001), and the relationship was stronger among women, urban residents and participants with BMI ≥24. Similar results were additionally observed when an age-balanced control group was used. CONCLUSIONS: Exposure to the Great Chinese Famine in early life after birth especially in infancy may be associated with a higher risk of RA in adulthood. Strengthening early-life nutrition could be an implication to prevent future RA.
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spelling pubmed-82585642021-07-23 Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study Liu, Chunyu Meng, Xiangrui Zhang, Hao Yang, Fan Pan, Xiaoyu Tang, Kun BMJ Open Public Health OBJECTIVE: This study aimed to explore the association between famine exposure in early life and the odds of rheumatoid arthritis (RA) in adulthood. DESIGN: A population-based retrospective cohort study. SETTING: China. PARTICIPANTS: A total of 111 706 participants (1775 with RA) born from 1956 to 1964 were selected from the baseline survey of a large cohort in China. PRIMARY AND SECONDARY OUTCOME MEASURES: Four famine exposure groups were generated based on dates of birth, namely prenatal-exposed, infant-exposed, preschool-exposed and non-exposed groups. Logistic regressions were used to explore the association between famine exposure and self-reported RA in adulthood, adjusting for sex, region, monthly income, highest education, alcohol consumption, tobacco use, body mass index (BMI) and metabolic equivalent tasks. Analyses were also performed with stratification for sex (female or male), residing region (urban or rural), famine severity (severe or non-severe) and BMI (≥24 or <24). RESULTS: The study included 1775 (1.59%) RA cases and 109 931 (98.41%) non-RA controls. Among them, 22 413 (20.06%) were prenatal-exposed, 14 899 (13.34%) were infant-exposed and 34 356 (30.76%) were preschool-exposed. Prenatal exposure to famine was not associated with onset of RA in adulthood. Infant-exposed group and preschool-exposed group had significantly elevated odds of getting RA compared with non-exposed group (infant-exposed: OR=1.44, 95% CI 1.24 to 1.67; preschool-exposed: OR=1.38, 95% CI 1.22 to 1.57, p<0.001), and the relationship was stronger among women, urban residents and participants with BMI ≥24. Similar results were additionally observed when an age-balanced control group was used. CONCLUSIONS: Exposure to the Great Chinese Famine in early life after birth especially in infancy may be associated with a higher risk of RA in adulthood. Strengthening early-life nutrition could be an implication to prevent future RA. BMJ Publishing Group 2021-07-05 /pmc/articles/PMC8258564/ /pubmed/34226211 http://dx.doi.org/10.1136/bmjopen-2020-043416 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Public Health
Liu, Chunyu
Meng, Xiangrui
Zhang, Hao
Yang, Fan
Pan, Xiaoyu
Tang, Kun
Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study
title Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study
title_full Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study
title_fullStr Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study
title_full_unstemmed Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study
title_short Early-life famine exposure and rheumatoid arthritis in Chinese adult populations: a retrospective cohort study
title_sort early-life famine exposure and rheumatoid arthritis in chinese adult populations: a retrospective cohort study
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258564/
https://www.ncbi.nlm.nih.gov/pubmed/34226211
http://dx.doi.org/10.1136/bmjopen-2020-043416
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