13 6 Vol13 No6 2009 6 12 Life Science Research Dec 2009 a,b,c, d b*,, e, a a b c d e 400016 : (Metabolic syndrome, MS), 2005~2008, 14 917 (1959~1961 ) 3 650 ( ), (1955~1957 ) 4 497 ( ) (1963~1965 ) 6 770 ( ), 3 4 MS, SAS91 MS MS 463, 1030%; MS 403, 1104%; MS 609, 900% MS 1 326, 1406% MS 149, 272% MS, MS > > >,,, : ; ; ; : R151 : A : 1007-7847(2009)06-0505-07 The Impact of Malnutrition Caused of Famine on the Adult Metabolic Syndrome GUAN Yun-liang a b c WANG Yong-hong d LI Ting-yu b* PENG Bin e ZHAO Yong a a Department of Nutrition and Food Hygiene Public Health School b Children s Hospital Children Nutrition Research Centre of Chongqing City c Editorial Department of Journal of Chongqing Medical University d Medical Examination Center the First Affiliated Hospital e Department of Health Statistics Chongqing Medical University Chongqing 400016 China Abstract The influence of the malnutrition which caused by the early-life food shortage malnutrition on the MS in people adulthoods was studied And the causes of the adult chronic diseases were explored and thus to provide the scientific reference for making better nutrition-improving policies for women and children 14 917 cases from the Personal Medical Examination Database data between 2005 and first half of 2008 of the Medical Examination Center in the First Affiliated Hospital of Chongqing Medical University were adopted 3 650 cases Group that were born during the Great Leap Forward famine 1959~ 1961 were chosen as the famine-affected population 4 497 cases Group born prior to the famine 1955~1957 and 6 770 cases Group born after the famine 1963~1965 were chosen as the nonfamine-affected population BMI glucose values blood pressure and cholesterol levels were compared between these three groups as the partial judgment for MS criteria SAS version 91 was used to analyze the occurrence of MS 463 cases from Group were diagnosed as MS accounting for 1030% of Group : 2009-06-30 : 2009-09-23 : 2008 08JC840021 : 1980- Tel 023-68485032 E-mail guanguan522@163com * 1956- Tel 023-63626904 E-mail tyli@vipsinacom
506 2009 403 cases from Group were diagnosed as MS accounting for 1104% of Group 609 cases from Group were diagnosed as MS accounting for 900% of Group Comparison between groups was statistically significant There were 1 326 male MS patients make a morbidity of 1406% while 149 female MS patients were diagnosed make a morbidity of 272% The early-life malnutrition in the famine period had influenced the occurrence of MS in people s adulthood The factors due to the severity for causing MS are as followed in descending order dyslipidmias overweight hypertension and hyperglycemia There is also a clear gender difference that the morbidity of male is significantly higher than that of female thus this difference is meaningful to statistics Therefore scientific supply and reasonable formula for the diets of the pregnant women wet nurses and infants are very important and can be used to improve the life quality of the entire population Key words earlier period of life malnutrition metabolic syndrome chronic disease Life Science Research 2009 13 6 505~511 Metabolic syndrome MS 1959~1961 3 650 [1] 6 1955~1957 4 497 1 1963~1965 6 770 MS 2 12 MS 121 [2,3] MS [4,5] 20 80 Barker [6~9] Barker 3 d [10~20] 1959~1961 20 8~12 h 1958~1961 4 TC-SGTZ-02 621 [21] 1997 Body mass index BMI 01 kg 001 m MS HEM-907 Barker MS 1 11 7170 2005~2008 122 14 917 2004 Chinese
6 : 507 diabetes society CDS MS 13 CDS 4 SAS91 [22] 3 1 Body mass index BMI 250 kg / m 2 2 Logistic P < 005 61 mmol / L 2 h 2 78 mmol / L 3 / 140 / 90 21 mmhg 1 18662 / 11997 kpa 14 917 4 9 430 6322% 5 487 17 mmol / L 3678% 1955~1957 4 High density lipoprotein HDL < 09 mmol / L 497 1959~1961 3 650 1963~1965 < 10 mmol / L 6 770 1 1 Table 1 The research object distribution according to of gender and birth time group Group Birth year Male n % Female n % Total Before the famine Middle of famine After the famine 1955~1957 1959~1961 1963~1965 2 816 6262 2 285 6260 4 329 6394 1 681 3738 1 365 3740 2 441 3606 4 497 3 650 6 770 22 MS 23 MS ± MS MS > 2 BMI > > 3 Group 2 MS (x ± s) Table 2 Indicator mean different gender and MS born group each single(x ± s) Every single indicator of MS BMI kg / m 2 Systolic pressure mmhg Diastolic pressure mmhg Blood glucose mmol / L Triglyceride mmol / L High-density lipoprotein mmol / L Male 2445 ± 281 12665 ± 1785 8192 ± 1270 526 ± 134 207 ± 172 128 ± 030 x ± s Female 2271 ± 272 12251 ± 1832 7561 ± 1179 498 ± 075 132 ± 087 161 ± 036 BMI kg / m 2 Systolic pressure mmhg Diastolic pressure mmhg Blood glucose mmol / L Triglyceride mmol / L High-density lipoprotein mmol / L 2462 ± 290 12588 ± 1724 8187 ± 1266 525 ± 133 225 ± 208 125 ± 030 2251 ± 260 11842 ± 1652 7471 ± 1146 498 ± 095 125 ± 091 157 ± 033 BMI kg / m 2 Systolic pressure mmhg Diastolic pressure mmhg Blood glucose mmol / L Triglyceride mmol / L High-density lipoprotein mmol / L 2458 ± 287 12387 ± 1618 8060 ± 1244 512 ± 117 215 ± 193 126 ± 029 2211 ± 261 11345 ± 1517 7249 ± 1111 487 ± 064 115 ± 088 156 ± 033 1 1 mmhg 0133 kpa
508 2009 Group 3 MS Table 3 The each single indicator overweight situation of different gender and MS born group Every single indicator of MS Systolic pressure overproof Diastolic pressure overproof Pressure overproof Triglyceride overproof High-density lipoprotein overproof Specific overweight n % Male Female Total 1 181 4194 307 1090 595 2113 692 2457 846 3004 1 272 4517 171 607 1 293 4592 311 1850 64 381 283 1684 199 1184 334 1987 344 2046 39 232 361 2148 1 492 3318 371 825 878 1952 891 1981 1 180 2624 1 616 3594 210 467 1 654 3678 Systolic pressure overproof Diastolic pressure overproof Pressure overproof Triglyceride overproof High-density lipoprotein overproof 1 010 4420 227 993 405 1772 555 2429 627 2744 1 175 5142 192 840 1 202 5260 217 1590 49 359 138 1011 128 938 184 1348 225 1648 42 308 241 1766 1 227 3362 276 756 543 1488 683 1871 811 2222 1 400 3836 234 641 1 443 3953 Systolic pressure overproof Diastolic pressure overproof Pressure overproof Triglyceride overproof High-density lipoprotein overproof 1 927 4451 288 665 612 1414 881 2035 1 015 2345 2 092 4833 302 698 2 131 4923 315 1290 50 205 125 512 170 696 215 881 313 1282 74 303 338 1385 2 242 3312 338 499 737 1089 1 051 1552 1 230 1817 2 405 3552 376 555 2 469 3647 24 (Metabolic abnor- 2801% 2 MA 2 953 mality, MA) 1980% 3 MA MA 14 917 1 251 839% 4 MA 1 MA 4 178 224 150% 4 4 MA Table 4 MA distribution of different gender and group (n, %) Sex Group 0 item 1 item 2 item 3 item 4 item Male 799 2837 607 2656 1 319 3047 884 3139 703 3077 1 298 2998 734 2607 617 2700 1 143 2640 321 1140 303 1326 499 1153 78 277 55 241 70 162 Female 937 5574 881 6454 1 768 7243 493 2933 324 2374 476 1950 187 1112 115 842 157 643 53 315 43 315 32 131 11 065 2 015 8 033 Total 1 736 3860 1 488 4077 3 087 4560 1 377 3062 1 027 2814 1 774 2620 921 2048 732 2005 1 300 1920 374 832 346 948 531 784 89 198 57 156 78 115 25 MS 5 MS 463 14 917 MS 1 326 1030% MS 403 1406% MS 149 1104% MS 609 900% 272% 5
6 : 509 26 MA MS 27 MS 6 MS Logistic MS MS MS 3 8 6 MA MS MS > BMI Logistic > > 5 MS Table 5 Respondents MS analysis situation(n, %) Group Male Female Gender comparison in each group Total χ 2 P 399 1417 64 381 122370 0 < 0000 1 463 1030 358 1567 45 330 133141 2 < 0000 1 403 1104 569 1314 40 164 252387 0 < 0000 1 609 900 χ 2 = 1178 2 P = 0277 7 χ 2 = 5305 8 P = 0021 3 χ 2 = 11315 7 P = 0000 8 Notes vs χ 2 = 1178 2 P = 0277 7 vs χ 2 = 5305 8 P = 0021 3 vs χ 2 = 11315 7 P = 0000 8 6 MA MS Table 6 MA distributionin in the diagnosis of MS(n, %) Item 1 item 2 item 3 item Total Blood pressure overproof 1 354 2729 123 1249 809 2512 1 892 3399 2 214 4463 300 3046 1 135 3524 2 257 4055 1 393 2808 562 5705 1 277 3964 1 417 2545 4 961 3326 985 660 3 221 2159 3 366 3731 7 MS Logistic Table 7 MS sicken Logistic regression factor and risk factors for assignment Factor Data assignment Unit Sex BMI Blood glucose Systolic pressure Diastolic pressure Triglyceride High-density lipoprotein 0 indicate male 1 indicate female 0 indicate 25 1 indicate < 25 0 indicate 61 1 indicate < 61 0 indicate 140 18662 1 indicate < 140 18662 0 indicate 90 11997 1 indicate < 90 11997 0 indicate 17 1 indicate < 17 Male: 0 indicate < 09 1 indicate 09 Female: 0 indicate < 10 1 indicate 10 kg / m 2 mol / L mmhg kpa mmhg kpa mmol / L mmol / L 8 MS Logistic Table 8 MS illness risk factors for Logistic regression analysis results of single factor Factor Regression coefficient Standard error Wald chi-square P value OR value 95% CI vs vs Sex BMI Blood glucose Systolic pressure Diastolic pressure Triglyceride High-density lipoprotein -0078 3-0227 6 0884 2 3850 2 2941 5 2630 0 3047 1 3852 0 1440 4 0072 1 0067 8 0044 1 0115 3 0072 9 0060 6 0064 7 0123 9 0082 6 1178 2 11280 1 402179 3 1 115258 6 1 627747 5 1 883080 5 2 216531 7 966899 1 304215 5 0277 7 0000 8 < 0000 1 < 0000 1 < 0000 1 < 0000 1 < 0000 1 < 0000 1 < 0000 1 0925 0796 5862 47001 18944 13874 21054 47088 4222 0083~01065 0697~00910 4931~06968 37495~58917 16421~21854 12320~15624 18546~23902 36937~60029 3591~04964
510 2009 3 14 917 1~3 3 MS 5 MS 463 1030% MS 403 1104% MS 609 900% 50 MS [22] 50 MS MS 1955~1957 > 1959~1961 > 1963~1965 MS 1104% Logistic MS MS 3 6 MS MS (References): [1] Third report of the national cholesterol education program NCEP expert on detection Evaluation and treatment of high blood cholesterol in adults adult treatment panel final report[j] Circulation 2002 106 3143-3421 [2] YO S NICKLAS T BARANOWSKI T et al Comparison of dietary intakes associated with metabolic syndrome risk factors in young adults The Bogalusa Heart Stndy[J] Am J Clin Nutr 2004 80 841-848 [3] [J] HU Yisong ZHAI Feng-ying HE Yu-na et al Relationship between metabolic syndrome and dietary nutrients[j] Public Health and Preventive Medicine 2008 19 1 20-23 [4] RICCARDI G RIVELLESE A A Dietary treatment of the metabolic syndrome-the optimal diet[j] British Journal of Nutrition 2000 83 Suppl 1 Sl43-S148 [5]
6 : 511 [J] GU Hai-bo TENG Ya-ping SHI Hai-hong et al Strengthening the effect on food intervention to metoblic index of metaboylic syndrome patient[j] Modern Hospital 2008 8 2 8-9 [6] BARKER D J P OSMOND C Infant mortality childhood nutrition and ischaemic heart disease in England and Walse [J] Lancet 1986 1 1077-1081 [7] BARKER D J P WINTER P D OSMOND C et al Weight in infancy and death from ischaemic heart disease[j] Lancet 1989 2 577-580 [8] BARKER D J P BULL A R OSMOND C et al Fetal and placental size and risk of hypertension in adult life[j] BMJ 1990 301 259-262 [9] GODFREY K M BARKER D J Fetal nutrition and adult disease[j] Am J Clin Nutr 2000 715 Suppl 1344s-1352s [10] MARJO R J ULLA S VANESSA K et al Early life factors and blood pressure at age 31 years in the 1996 Northern Finland birth cohort[j] Hypertension 2004 44 838-846 [11] ALAN B JIM V O CORINE D et al Further evidence of relation between prenatal famine and major affective disorder [J] Am J Psychiatry 2000 157 190-195 [12] RICHARD N HANS W H EZRA S Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood[j] JAMA 1999 282 455-462 [13] RICH-EDWARDS J W COLDITZ G A STAMPFER M J et al Birth weight and the risk for type 2 diabetes mellitus in adult women[j] Ann Intern Med 1999 130 1 278-284 [14] JIE M CATHERINE L ZHANG K L et al Effects of infants birth weight and maternal body mass index in pregnancy on components of insulin resistance syndrome in China[J] Ann Intern Med 2000 132 253-260 [15] RAVELL I van der MEULEN J H OSMOND C et al Obesity at the age of 50 in men and women exposed to famine prenatally[j] Am J Clin Nutr 1999 70 811-816 [16] HALES C N BARKER D J CLARK P M et al Fetal and infant growth and impaired glucose tolerance at age 64 [J] BMJ 1991 303 1019-1022 [17] LITHELL H O MCKEIGUE P M BERGLUND L et al Relation of size at birth to non insulin dependent diabetes and insulin concentrations in men aged 50~60 years[j] BMJ 1996 312 406-410 [18] mccanee D R PETTITT D J HANSON R L et al Birth weight and non-insulin dependent diabetes thrifty genotype thrifty phenotype or surviving small baby genotype?[j] BMJ 1994 308 942-945 [19] FORSEN T ERIKSSON J TUOMILEHTO J et al The fetal and childhood growth of persons who develop type 2 diabetes [J] Ann Intern Med 2000 133 176-182 [20] NEWSORNE C A SHLELL A W FAU C H et al Is birth weight related to later glucose and insulin metabolism? A systematic review[j] Diabet Med 2003 20 339-348 [21] [J] WANG Z The most grieved disaster of new Republic of China great famine in three years[j] Wan Xia Data Collection 2006 11 53-55 [22] [J] Chinese Diabetes Society of Chinese Medical Association Suggestions for metabolic sysdrome [J] Chinese Journal of Diabetes 2004 12 3 156-161