Early-life exposure to the Chinese famine of 1959-61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study

BMC Public Health. 2020 Jan 6;20(1):15. doi: 10.1186/s12889-019-8017-1.

Abstract

Background: Short-term starvation has been related to hyperuricemia. However, little is known about the long-term effect of early-life exposure to famine on hyperuricemia risk in adulthood.

Methods: The analysis included 2383 participants from the China Health and Retirement Longitudinal Study in 2015. Hyperuricemia was diagnosed as serum uric acid ≥7 mg/dL in men and serum uric acid ≥6 mg/dL in women. Famine exposure subgroups were defined as unexposed (born between October 1, 1962, and September 30, 1964), fetal-exposed (born between October 1, 1959, and September 30, 1961), and early-childhood exposed (born between October 1, 1956, and September 1, 1958). The association between early-life famine exposure and hyperuricemia risk was assessed using multivariate logistic regression.

Results: The prevalence of hyperuricemia in the unexposed, fetal-exposed, and early-childhood exposed participants was 10.7, 14.1, 11.1%, respectively. Compared with unexposed and early-childhood exposed participants combined as an age-balanced control, fetal-exposed participants showed an increased risk of hyperuricemia in adulthood (OR = 1.41; 95% CI: 1.06-1.88), after adjusting for gender, marital status, famine severity, residence, smoking, drinking, BMI, hypertension, and diabetes. The famine effect on hyperuricemia was accentuated by overweight or obesity (P for interaction = 0.042). Compared with unexposed and BMI < 24 kg/m2 participants, the OR (95%CI) of hyperuricemia was 3.66 (2.13-6.30) for fetal-exposed and overweight/obesity participants. However, combined unexposed and early-childhood exposed participants as an age-balanced control, the interaction of famine exposure and BMI was not statistically significant (P for interaction = 0.054).

Conclusion: Famine exposure in the fetal stage was associated with an increased risk of hyperuricemia in adulthood.

Keywords: Hyperuricemia; Prenatal exposure delayed effects; Starvation.

MeSH terms

  • Adverse Childhood Experiences / statistics & numerical data*
  • China / epidemiology
  • Famine / statistics & numerical data*
  • Female
  • Humans
  • Hyperuricemia / epidemiology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Risk Factors