title: Famine in childhood and postmenopausal coronary artery calcification: a cohort study.
abstract: OBJECTIVE
  To assess the effects of famine exposure during childhood on coronary calcium deposition and, secondarily, on cardiac valve and aortic calcifications.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Community.
  
  
  METHODS
  286 postmenopausal women with individual measurements of famine exposure during childhood in the Netherlands during World War II.
  Famine exposure during childhood.
  
  
  METHODS
  Coronary artery calcifications measured by CT scan and scored using the Agatston method; calcifications of the aorta and cardiac valves (mitral and/or aortic) measured semiquantitatively. Logistic regression was used for coronary Agatston score of >100 or ≤100, valve or aortic calcifications as the dependent variable and an indicator for famine exposure as the independent variable. These models were also used for confounder adjustment and stratification based on age groups of 0-9 and 10-17 years.
  
  
  RESULTS
  In the overall analysis, no statistically significant association was found between severe famine exposure in childhood and a high coronary calcium score (OR 1.80, 95% CI 0.87 to 3.78). However, when looking at specific risk periods, severe famine exposure during adolescence was related to a higher risk for a high coronary calcium score than non-exposure to famine, both in crude (OR 3.47, 95% CI 1.00 to 12.07) and adjusted analyses (OR 4.62, 95% CI 1.16 to 18.43). No statistically significant association was found between childhood famine exposure and valve or aortic calcification (OR 1.66, 95% CI 0.69 to 4.10).
  
  
  CONCLUSIONS
  Famine exposure in childhood, especially during adolescence, seems to be associated with a higher risk of coronary artery calcification in late adulthood. However, the association between childhood famine exposure and cardiac valve/aortic calcification is less clear.
authors.affiliation: Cardiology Division, Department of Child Health, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Nikmah S
authors.initials: NS
authors.lastname: Idris
authors.forename: Cuno S P M
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: Annet F M
authors.initials: AF
authors.lastname: van Abeelen
authors.forename: Tessa J
authors.initials: TJ
authors.lastname: Roseboom
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.forename: Annemarieke
authors.initials: A
authors.lastname: Rutten
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Sjoerd G
authors.initials: SG
authors.lastname: Elias
keywords: EPIDEMIOLOGY; NUTRITION & DIETETICS