生命早期饥荒暴露与成年期高血压患病风险的关联分析

Association analysis of famine exposure during early life and risk of hypertension in adulthood

目的探讨生命早期饥荒暴露与成年期高血压患病风险的关联。方法利用宜昌市健康管理大数据中心就诊日期为2018—2019年的就诊资料,采用回顾性队列研究设计,以高血压为研究结局,以不同生命时期暴露于中国大饥荒进行分组。采用多因素logistic回归模型分析生命早期饥荒暴露与成年期罹患高血压的关联,同时分析性别与饥荒暴露的交互作用。结果142016名研究对象年龄为(60.56±4.43)岁,其中男性占46.36%(65845/142016),女性占53.64%(76171/142016);非饥荒暴露组、胎儿期饥荒暴露组、儿童早期饥荒暴露组、儿童中期饥荒暴露组和儿童晚期饥荒暴露组的研究对象分别有42575例(29.98%)、19644例(13.83%)、28405例(20.00%)、28305例(19.93%)、23087例(16.26%);高血压患病率为17.57%(24947例)。多因素logistic回归模型分析结果显示,调整相关混杂因素后,与非饥荒暴露组相比,胎儿期、儿童早期、儿童中期和儿童晚期饥荒暴露组高血压患病风险较高,OR(95%CI)值分别为1.16(1.11~1.22)、1.27(1.21~1.33)、1.54(1.47~1.60)、1.84(1.76~1.92);性别与饥荒暴露分组具有交互作用(P<0.001),女性人群中的上述关联更强。结论生命早期饥荒暴露可能增加成年期罹患高血压的风险,且女性的风险更大。

Objective To explore the relationship between exposure to famine in early life and the risk of hypertension in adulthood.Methods The medical data of Yichang Health Management Big Data Center from 2018 to 2019 were analyzed.A retrospective cohort study design was adopted,with hypertension as the study outcome,and different life periods exposed to the Great Famine in China were divided into groups.Multivariate logistic regression model was used to analyze the relationship between famine exposure in early life and hypertension in adulthood.At the same time,the interaction between gender and famine exposure was analyzed.Results The age of 142016 subjects was(60.56±4.43).Among them,men accounted for 46.36%(65845/142016)and women accounted for 53.64%(76171/142016).There are 42575(29.98%),19644(13.83%),28405(20.00%),28305(19.93%),23087(19.93%)in non-famine exposure group,fetal famine exposure group,early childhood famine exposure group and late childhood famine exposure group,respectively.The prevalence of hypertension was 17.57%(24947 cases).Multivariate logistic regression model analysis showed that after adjusting for related confounding factors,compared with non-famine exposure group,the risk of hypertension in fetal,early childhood,middle childhood and late childhood famine exposure group was higher and the OR(95%CI)values were 1.16(1.11-1.22),1.27(1.21-1.33),1.54(1.47-1.60)and 1.84(1.76-1.92),respectively.There was an interaction between sex and famine exposure group(P<0.001).The above association is stronger among women than among men.Conclusion Famine exposure in early life may increase the risk of hypertension in adulthood,and the risk of women is greater than that of men.