Key result
Fetal famine exposure is linked to ~21% higher CV risk in those with ≤2 ideal health metrics.
Why the study?
No study had explored whether ideal cardiovascular health metrics modify the association between early-life famine exposure and the risk of CVD in adulthood.
Does exposure to Chinese famine in early life increase the risk of CVD in adulthood, and do ideal cardiovascular health metrics modify this risk?
Cohort (n=61,527)
Yes
Does exposure to Chinese famine in early life increase the risk of CVD in adulthood, and do ideal cardiovascular health metrics modify this risk?
Maintaining ideal cardiovascular health metrics can mitigate the increased risk of cardiovascular disease associated with fetal exposure to famine.
Ideal CV health metrics may offset famine-related CVD risk; extends observational data on early-life adversity modification.
Background: No study has explored the modification effect of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and risk of cardiovascular disease (CVD) so far. We aim to examine the effect of ICVHMs on the association between exposure to famine early in life and the risk of CVD in adulthood. Methods: A total of 61,527 participants free of CVD were included in this study from the Kailuan Study. All participants were divided into three groups, included nonexposed, fetal-exposed, and childhood-exposed groups. Cox regression was used to estimate the effect of famine exposure and ICVHMs on CVD risk. Results: After a median of 13.0 (12.7–13.2) years follow-up, 4,814 incident CVD cases were identified. Compared with nonexposed participants, the CVD risk increased in participants with fetal famine exposure (hazard ratio [HR]: 1.21; 95% CI: 1.07–1.37), but not in childhood famine-exposed participants. After stratifying by the number of ICVHMs, the increased CVD risk associated with fetal famine exposure was only observed in participants with less ICVHMs ( ≤ 2) (HR: 1.30; 95% CI: 1.11–1.52, P for interaction=0.008), but disappeared in those with three or more ICVHMs. The modified effect of ICVHMs was sex specific ( P for sex interaction = 0.031). Conclusions: Exposing to famine in the fetal period could increase the risk of CVD in late life; however, ICVHMs might modify the effect of famine exposure on CVD risk, especially in men.
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Ding et al. (2021) conducted a cohort in Cardiovascular disease (n=61,527). Fetal exposure to the Great Chinese Famine vs. Nonexposed group (born 1963-1974) was evaluated on Incident cardiovascular disease events (HR 1.21, 95% CI 1.07-1.37). Fetal exposure to the Chinese Famine increased cardiovascular disease risk (HR 1.21) compared to nonexposed individuals, but this was only observed in those with ≤2 ideal cardiovascular health metrics.
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