Early exposure to Great Chinese Famine linked to NAFLD in women
Sex-specific associations may exist between exposure to the Great Chinese Famine in early life and later development of moderate to severe nonalcoholic fatty liver disease, according to recent findings.
Yingli Lu, MD, PhD, director of endocrinology and metabolism at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine in Shanghai, and colleagues evaluated data from 5,306 participants in the SPECT-China study, a cross-sectional analysis of the prevalence of metabolic diseases and risk factors in eastern China. Study participants were stratified into four groups based on their life stages when exposed to famine between 1959 and 1962: fetal exposure (n = 712) for participants born between 1959 and 1962; childhood exposure (n = 1,778) for those born between 1949 and 1958; adolescent/young adult exposure (n = 1,076) for birth years 1921 to 1948; and nonexposed (n = 1,740) for those born between 1963 and 1974. All participants underwent abdominal ultrasound to measure fat accumulation. Researchers compared the degrees of steatosis of nonalcoholic fatty liver disease (NAFLD) in terms of age at exposure to famine.
Among men, the rates of NAFLD were 55.9% in the nonexposed group, 55.8% in the fetal-exposed group and 55.4% in childhood-exposed participants. Among women, the prevalence of NAFLD was 33% in nonexposed participants, 46.3% in the fetal-exposed group and 51.7% in the childhood-exposed group. Compared with the nonexposed reference group, women with fetal and childhood exposure had a higher rate of moderate-severe steatosis, whereas no such disparity was seen in men (P < .05). After adjustment for age, rural/urban residence, economic status, BMI, and diabetes, dyslipidemia and hypertension, researchers noted an association between elevated alanine aminotransferase and both fetal and childhood exposure to famine in women (both P < .05). In the fully adjusted model, exposure to famine in utero (OR = 1.77; 95% CI, 1.22-2.57) and in childhood (OR = 1.82; 95% CI, 1.35-2.46) were correlated with increased rates of moderate-severe NAFLD in women. Additional adjustment for BMI, diabetes and hypertension did not diminish this association.
“Our study indicated that nutrition in early life may partly influence the development of NAFLD,” the researchers wrote. “Exposure to the Great Famine in utero and during childhood was associated with moderate-severe NAFLD in women. This suggests that pregnant women and their infants and children may require the highest priority in obtaining nutritional relief.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures