生命早期饥荒暴露与成年期体质指数的关联分析

目的 研究生命早期饥荒暴露对成年期BMI的影响。方法 研究对象来自中国慢性病前瞻性研究的基线调查，共94 052名研究对象纳入分析。将出生于1956年10月至1958年9月、1959年10月至1961年9月和1962年10月至1964年9月的研究对象分别划分为饥荒前出生组、饥荒期内出生组和饥荒后出生组（对照组）。采用线性回归模型计算饥荒暴露组成年期BMI的回归系数及其95%CI。采用似然比检验计算吸烟、饮酒和体力活动与饥荒暴露交互作用的P值。结果 在调整了其他影响因素后，仅在女性中发现，与饥荒后出生组相比，饥荒期内出生组成年期BMI较高（β=0.12，95%CI：0.03～0.22）。吸烟、饮酒均对饥荒与BMI间的关联存在效应修饰作用（交互作用均P<0.001），体力活动不存在（交互作用P=0.077）。结论 生命早期经历饥荒，尤其是胎儿期经历饥荒的女性成年期BMI较高。因此，保证生命早期营养水平对预防成年后超重/肥胖的发生具有重要意义。

Association between famine exposure during early life and BMI in adulthood

Objective To examine the influence of famine exposure during early life on BMI in adulthood. Methods A total of 94 052 participants recruited in the baseline survey of China Kadoorie Biobank were included in this study. The participants who were born between October 1956 and September 1958, between October 1959 and September 1961 and between October 1962 and September 1964 were classified as group born before famine, group born during famine and group born after famine (control group). The regression coefficients and 95% confidence intervals (CIs) for BMI of famine exposure groups were estimated by linear regression model. And P values for interaction between famine and smoking, alcohol use, physical activity were estimated by likelihood ratio tests. Results Compared with the group born after famine, in females, the group born during famine had higher BMI (coefficient: 0.12, 95%CI: 0.03-0.22) after adjusting other impact factors. Except physical activity (interaction: P<0.077), both smoking and alcohol use had modification effects on the associations between famine exposure and BMI (interaction: all P<0.001). Conclusion Famine exposure during early life, especially during fetal period, might increase risks of overweight and obesity in females. Therefore, it is important to ensure the adequacy of nutrition during early life to prevent overweight or obesity in adulthood.