早期饥荒暴露与成年后蛋白尿的风险的关联研究

Exposure to the Chinese famine in early life and the risk of microalbuminuria in adulthood

目的研究1959-1961年自然灾害饥荒暴露与成年后微量白蛋白尿发生风险的相关性,探讨胎儿和儿童期营养缺乏是否为成年后白蛋白尿发生的危险因素。方法 2011年6月至2012年1月在福建宁德及武夷山地区进行普通人群筛查,共入组4 504例于1953-1964年出生的受检者。按照出生时间分为4个组。1959-1961年出生者为胎儿期饥荒暴露组,1956-1958年出生者为儿童早期暴露组,1953-1955年出生者为儿童晚期暴露组,1962-1964年出生者为非暴露组。使用多元Logistics回归分析分析不同饥荒暴露组与非暴露组成年后微量白蛋白尿的校正比值比(OR)。结果以非暴露组为对照组,经校正年龄、体质量指数(BMI)、收缩压、空腹血糖、吸烟、饮酒等因素后,结果显示女性受试者胎儿期、儿童早期和儿童晚期饥荒暴露者成年后发生微量白蛋白尿的风险较非饥荒暴露组显著升高,OR及95%CI分别为1.880(1.038~3.405)(P=0.037),3.446(1.327~8.945)(P=0.011)和6.817(1.698~27.366)(P=0.007)。结论胎儿期和儿童期饥荒暴露与女性成年后出现白蛋白尿的风险存在显著的相关性,且这种相关性是独立于血糖、血压、BMI、吸烟和体力活动水平而独立存在的。

Objective To investigate whether exposure to the Chinese famine during fetal life and childhood is associated with the risks of microalbuminuria.Methods A total of 4 504 participants born between 1953 and 1964were included in the study.Famine exposure groups were defined as nonexposed;fetal exposed;and early childhood,or late childhood exposed.Multiple logistic regression models were used to analyze the odds ratio and 95% CI of microalbuminuria associated with exposure to famine,after adjustment for potential confounders,such as age,BMI,smoking status,alcohol consumption,physical activity,fasting glucose as well as systolic blood pressure.Results Female who were exposed to the famine during fetal life,early childhood and late children had a higher risk of microalbuminuria,as compared with nonexposed subjects(odds ratio 1.880[95% CI 1.038~3.405,P=0.037],3.446 [95% CI 1.327~8.945,P=0.011],6.817 [95% CI 1.698~27.366,P=0.007],respectively).Conclusion Exposure to the Chinese famine during fetal life or childhood is associated with an increased risk of microalbuminuria in adulthood for female.