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Association of Adolescent Exposure to Famine With Low Bone Mass in Adulthood
16 Pages Posted: 7 Mar 2022
More...Abstract
Background: Famine exposure in early life have long-term effects on human health, but its effect on bone health is not clear. We aimed to investigate the association between early-life famine exposure and bone mass in adulthood.
Methods: Participants were enrolled from the China Osteoporosis Prevalence Study (COPS), a national and population-based cohort. Participants were classified into three famine-exposed groups according to their life stages when exposed to the Great Chinese Famine: fetal-famine exposed (birth year 1959-1962), early-life famine exposed (birth year 1949-1962), and adolescence-famine exposed (birth year 1941-1950). Bone mineral density (BMD) was estimated by DXA. The association of famine exposure with bone mass was assessed via linear regression.
Findings: In men, the adolescence-famine exposed group had similar BMD at the lumbar spine, femur neck (FN), and total hip (TH) compared to the non-exposed group. However, in women, the adolescence-famine exposure group had significantly decreased bone mass at the FN and TH compared to the age-matched non-exposed group. Multiple linear regression analysis showed that famine exposure during adolescence was negatively associated with BMD at the FN and TH in adulthood (β -14·50, 95% CI -24·90, -4·09, p = 0·006 for FN; β -13·93, 95% CI -24·95, -2·90, p = 0·013 for TH) after adjusting for age, BMI, rural residency, and menopause status in women.
Interpretation: Famine exposure during adolescence is associated with decreased bone mass in older females. Our findings provide evidence for the adverse effect of famine exposure on bone health and the importance of timing of famine exposure.
Funding Information: Chinese Central Government Key Project of Public Health Program and Chinese Red Cross Foundation.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: The study protocol was approved by the ethical review committee of the Chinese Center for Disease Control and Prevention. We obtained written informed consent from all study participants, and confidentiality of information was assured.
Keywords: famine exposure, adolescence, bone mineral density, osteoporosis
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