生命早期饥荒暴露与成年后心血管代谢性疾病和共病的关联性研究  

Relevance study between early life famine exposure and cardiometabolic diseases or cardiometabolic multimorbidity after being an adult

作　　者：高慧 万金豹 朱旭婷 姜玉[1] 庄建林[1] 王英全 葛峥 马亦旸 娄蓓群 张磊[1] GAO Hui;WAN Jin-bao;ZHU Xu-ting;JIANG Yu;ZHUANG Jian-lin;WANG Ying-quan;GE Zheng;MA Yi-yang;LOU Bei-qun;ZHANG Lei(Changning Center for Disease Control and Prevention,Shanghai 200051,China;Baoshan Center for Disease Control and Prevention,Shanghai 201901,China;不详)

机构地区：[1]上海市长宁区疾病预防控制中心,上海200051 [2]上海市宝山区疾病预防控制中心,上海201901 [3]上海市疾病预防控制中心 [4]上海市长宁区华阳社区卫生服务中心 [5]上海市长宁区仙霞社区卫生服务中心 [6]上海市长宁区新华社区卫生服务中心

出　　处：《中国慢性病预防与控制》2023年第2期86-89,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家重大公共卫生项目(Z195110010004)。

摘　　要：目的 探究生命早期饥荒暴露与成年后心血管代谢性疾病和共病之间的关联,为进一步完善针对生命早期的营养政策提供科学依据。方法 数据来源于2016—2020年在上海市长宁区和宝山区开展的心血管病高危人群早期筛查与综合干预子项目,招募29 535名35~75岁常住居民进行问卷调查、体格检查和实验室检测。生命早期饥荒暴露的判定依据出生日期,将研究对象分为无暴露组(1962—1984年出生)、宫内暴露组(1959—1961年出生)、儿童期暴露组(1948—1958年出生)和青少年期暴露组(1941—1947年出生)。采用R 4.1.2软件进行多因素logistic回归分析生命早期饥荒暴露与成年后心血管代谢性疾病和共病之间的关联。结果 29 535名研究对象中,无暴露组9 348人,宫内暴露组2 319人,儿童期暴露组14 565人,青少年期暴露组3 303人。多因素logistic回归分析结果显示,相较于无暴露组,3个暴露组人群糖尿病、卒中和心血管代谢性疾病的患病风险均显著升高,宫内暴露组、儿童期暴露组冠心病患病风险显著升高,差异均有统计学意义(P<0.01)。以无暴露组为参照,宫内暴露组(OR=2.30,95%CI:1.27~4.18)、儿童期暴露组(OR=3.39,95%CI:1.88~6.26)、青少年期暴露组(OR=4.95,95%CI:2.28~10.95)心血管代谢性共病的患病风险更高(P<0.05)。结论 生命早期饥荒暴露会增加成年后心血管代谢性疾病和共病的患病风险。因此,改善生命早期的营养健康状况,可以降低个体成年后心血管代谢性疾病的发病风险。Objective To explore the relevance between early life famine exposure and cardiometabolic diseases or cardiometabolic multimorbidity after being an adult,and provide the scientific basis for improving the early life nutrition policy. Methods The data were from the sub-project of "Early Screening and Intervention of Population with High Risk of Cardiovascular Disease",carried out in Changning and Baoshan Districts of Shanghai from 2016 to 2020,29 535 permanent residents(35-75 years old) from the target communities were selected as the subjects,the investigation was performed with questionnaire,physical examinations and laboratory tests. The early life famine exposure was determined by the birthday,the subjects were divided into four famine exposure groups,including non-exposure group(born from 1962 to 1984),fetal exposure group(born from 1959 to 1961), childhood exposure group(born from 1948 to 1958),and adolescent exposure group(born from 1941 to 1947). Multivariate logistic regression analysis was used to analyze the relationship between early life famine exposure and cardiometabolic diseases(diabetes,coronary heart disease,stroke) and cardiometabolic multimorbidity(two or more of the three diseases) after being an adult. The used software was R 4.1.2. Results Among 29 535 subjects,9 348 cases were in the non-exposure group,2 319 cases were in the fetal exposure group,14 565 cases were in the childhood exposure group,and 3 303 cases were in the adolescent exposure group. Multivariate logistic regression analysis showed that as compared with the non-exposure group,the risk of diabetes,stroke,and cardiometabolic diseases in the three exposed groups significantly increased,the risk of coronary heart disease in fetal exposure group and childhood exposure group significantly increased(P<0.01);as comparing with the non-exposure group,the risk of cardiometabolic multimorbidity in the fetal exposure group(OR=2.30,95%CI:1.27-4.18),the childhood exposure group(OR=3.39,95%CI:1.88-6.26),the adolescent exposure group(OR=4.95

关 键 词：生命早期 饥荒暴露 心血管代谢性疾病 心血管代谢性共病 

分 类 号：R54[医药卫生—心血管疾病] R58[医药卫生—内科学]