Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period
Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period
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DOI：
10.1093/ije/dyu193
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发表时间：
2014-12-01
影响因子：
7.7
通讯作者：
Martorell, Reynaldo
中科院分区：
文献类型：
--
作者：
Huang, Cheng;Guo, Chaoran;Martorell, Reynaldo
背景资料：动物模型表明，妊娠期和产后早期营养不良可能对肾脏发育产生不利影响，并损害肾功能。作为一个自然实验，饥荒提供了一个机会来测试人类的这种潜在影响。我们评估了在妊娠期和产后早期暴露于1959-1961年中国饥荒是否与暴露于饥荒30年后女性成年人的蛋白尿水平相关。方法：我们使用队列规模收缩指数来测量饥饿强度，并构建了一个差异中的差异模型来比较蛋白尿水平，蛋白尿水平是通过对随机尿液样本进行试纸测试来测量的，中国女性中（n = 70 543），其饥荒暴露状态在出生队列中各不相同结果：饥荒暴露与高风险相关[OR = 1.54，95%可信区间（CI）：1.04，2.28; P = 0.029），有较高水平的蛋白尿的妇女出生在饥荒年（1959-61年）相比，未暴露的饥荒后出生的队列（1964-65年）在农村样本。在城市样本中没有观察到相关性。结果是强大的调整协变量。结论：严重的营养不良在妊娠期和产后早期可能有长期的影响，在人类的蛋白尿水平，但影响的大小可能很小。
Background: Animal models have suggested that undernutrition during gestation and the early postnatal period may adversely affect kidney development and compromise renal function. As a natural experiment, famines provide an opportunity to test such potential effects in humans. We assessed whether exposure to the Chinese famine of 1959-1961 during gestation and early postnatal life was associated with the levels of proteinuria among female adults three decades after exposure to the famine.Methods: We measured famine intensity using the cohort size shrinkage index and we constructed a difference-in-difference model to compare the levels of proteinuria, measured with a dipstick test of random urine specimens, among Chinese women (n = 70 543) whose exposure status to the famine varied across birth cohorts (born before, during or after the famine) and counties of residence with different degrees of famine intensity.Results: Famine exposure was associated with a greater risk [ odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.04, 2.28; P = 0.029) of having higher level of proteinuria among women born during the famine years (1959-61) compared with the unexposed post famine-born cohort (1964-65) in rural samples. No association was observed among urban samples. Results were robust to adjustment for covariates.Conclusions: Severe undernutrition during gestation and the early postnatal period may have long-term effects on levels of proteinuria in humans, but the effect sizes may be small.