生命早期饥荒对成年后骨质疏松的影响

The impact of early life exposure to famine on osteoporosis in adulthood

目的探讨生命早期经历饥荒对成年后骨质疏松的影响。方法采用2013年重庆某体检中心资料,选取1956年-1965年出生的3951例人员作为研究对象。将其中1956年-1958年与1963年-1965年出生人群合并作为对照组,分别比较1959年-1962年出生人群共四组与对照组在骨质疏松患病率上的差异。采用累积Logistic回归模型分析生命早期经历饥荒对成年后骨质疏松的影响。结果 1956年-1965年出生人群骨质疏松患病率为2.18%,其中对照组以及出生于1959年、1960年、1961年、1962年人群骨质疏松患病率分别为2.32%、0.84%、1.75%、3.53%、1.62%。骨质疏松患病率随年龄增长有升高趋势（Z=19.95,P〈0.001）,且男性高于女性（Z=13.3119,P〈0.001）。累积Logistic回归分析显示,调整其余自变量后,生命早期经历饥荒对成年后骨质疏松有影响,与对照组相比,1960年出生人群OR值为0.712（95%CI：0.520-0.975,P=0.034）,性别分层后,1960年出生男性人群OR值为0.569（95%CI：0.374-0.868,P=0.009）,1961年出生男性人群OR值为1.339（95%CI：1.000-1.792,P=0.050）,1960年出生女性人群OR值为1.012（95%CI：0.639-1.601,P=0.961）。结论生命早期经历饥荒对成年后骨质疏松有一定影响,主要表现在男性群体中。

Objective To investigate the effects of famine-experience during early life on osteoporosis in adulthood. Methods A total of 3951 subjects born between 1956 and 1965 and attended the health examination at health screening center in 2013 were recruited. People born from 1956 to 1958 and from 1963 to 1965 were combined as control group. The prevalence of osteoporosis among subjects born from 1959 to 1962 and the controls was compared respectively. The effect of famine in early life on osteoporosis in adulthood was examined using a cumulative logistic regression model. Results The prevalence of osteoporosis among subjects born from 1956 to 1965 was 2. 18%. Prevalence of osteoporosis among subjects born in 1959,1960,1961,1962,and the non-exposed group was 0. 84%,1. 75%,3. 53%,1. 62%,and 2. 32%,respectively. The prevalence of osteoporosis increased with the age（ Z = 19. 95,P〈0. 001） and was significantly higher in males than in females（ Z = 13. 3119,P〈0. 001）.Results from the cumulative logistic regression analysis showed that experience of famine during early life had impact on osteoporosis in adulthood after adjustment of the other variables. The odds ratio was 0. 712（ 95% CI： 0. 520- 0. 975,P = 0. 034） in people born in 1960,comparing with the control group. After stratification by gender,odds ratio in males born in 1960 and 1961 was 0. 569（ 95% CI： 0. 374-. 868,P = 0. 009） and 1. 339（ 95% CI： 1. 000- 1. 792,P = 0. 050）,respectively. The odds ratio in females born in 1960 was 1. 012（ 95% CI： 0. 639- 1. 601,P = 0. 961） after adjustment of the other variables. Conclusion Experience of famine during early life has impact on osteoporosis in adulthood and the effect mainly exists in males.