title: Exposure to Famine in Early Life and Nonalcoholic Fatty Liver Disease in Adulthood.
abstract: Epidemiologic studies have indicated that early life nutrition influences later risk of obesity, type 2 diabetes, and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is also considered a metabolic disease.
  
  
  
  The aim was to explore the association between adult NAFLD and fetal or childhood exposure to Great Chinese Famine between 1959 and 1962 during fetal and childhood period.
  
  
  
  In total, 5306 subjects from the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors study were divided into a fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/young adult-exposed (1921-1948), and nonexposed (1963-1974, reference) group.
  
  
  
  The degrees of steatosis of NAFLD were determined by ultrasonography.
  
  
  
  The prevalences of NAFLD in the nonexposed (1963-1974), fetal-exposed, and childhood-exposed participants were 55.9%, 55.8%, and 55.4% in men and 33.0%, 46.3%, and 51.7% in women, respectively. Compared with those nonexposed, fetal- and childhood-exposed women but not men had a significantly higher prevalence of moderate-severe steatosis (P < .05). A significant association existed in women between increased alanine aminotransferase and both fetal and childhood exposure to famine, after adjusting for age, rural/urban residence, economic status, body mass index, diabetes, dyslipidemia, and hypertension (both P < .05). Famine exposure during the fetal period (odds ratio 1.77, 95% confidence interval 1.22, 2.57) and childhood (odds ratio 1.82, 95% confidence interval 1.35, 2.46) was associated with an increased prevalence of moderate-severe NAFLD in women in the above fully adjusted model.
  
  
  
  Exposure to the Great Famine in early life had sex-specific association with moderate-severe NAFLD. This indicates that malnutrition in early life may influence the development of adult NAFLD; thus pregnant women and their infants and children may require the highest priority in obtaining nutritional relief.
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Ningjian
authors.initials: N
authors.lastname: Wang
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Ning
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Bing
authors.initials: B
authors.lastname: Han
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Chunfang
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Yingchao
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Fangzhen
authors.initials: F
authors.lastname: Xia
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Boren
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Bingshun
authors.initials: B
authors.lastname: Wang
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Xiaojin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Jensen
authors.affiliation: Institute and Department of Endocrinology and Metabolism (N.W., YiChen., Z.N., Q.L., B.N., C.Z., Yin.Chen, F.X., B.J., Y.L.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China; Department of Biostatistics (B.W., X.W.), Shanghai JiaoTong University School of Medicine, Shanghai 200025, China; and Endocrine Research Unit (M.D.J.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Yingli
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D015992:Body Mass Index; D002681:China; D005260:Female; D005869:Ghana; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012737:Sex Factors; D012750:Seychelles; D013217:Starvation / Q000150:complications / Q000000981:diagnostic imaging*; D001741:Black or African American