Early life famine exposure, adulthood obesity patterns and the risk of nonalcoholic fatty liver disease.

Abstract

Early life exposure to famine and adulthood obesity increased the risk of nonalcoholic fatty liver disease (NAFLD) in adulthood. However, the joint effects on adulthood NAFLD risk are not clear. This study aimed to explore the joint effects of famine exposure and adulthood obesity on NAFLD risk in later life. We included 7632 subjects aged ≥40years from a community-dwelling population. Participants were divided into 4 famine exposure groups according to the birth year, including nonexposed (1963-1974), fetal-exposed (1959-1962), childhood-exposed (1949-1958) and adolescent-exposed (1941-1948). General obesity was assessed by body mass index (BMI: overweight ≥24.0kg/m2 , obesity ≥28.0kg/m2 ) and abdominal obesity assessed by waist-to-hip ratio (WHR, men/women: moderate ≥0.90/0.85, high ≥0.95/0.90). Compared with nonexposed, fetal- and childhood-exposed participants show an increased risk of NAFLD with multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) of 1.28 (1.02-1.61) and 1.40 (1.04-1.88) respectively. After further adjusting BMI and WHR, the increased risk was observed only in childhood-exposed participants (OR=1.46, 95% CI=1.04-2.05). Significant interaction between famine exposure and general obesity on the risk of NAFLD was observed in women (P for interaction=.02). No significant interactions were detected between famine exposure and abdominal obesity (all P for interaction >.05). Compared with normal-BMI and -WHR participants, those with both general and abdominal obesity in adulthood had 20.74 (95% CI: 12.00-35.96), 14.45 (8.76-23.86), 23.02 (16.28-32.57) and 13.04 (8.30-20.48)-fold higher risk in nonexposed, fetal-, childhood- and adolescent-exposed groups respectively. Coexistence of early life famine exposure and adulthood obesity was associated with a higher risk of NAFLD.