Individual and Combined Effect of Famine Exposure and Obesity Parameters on Dyslipidemia in Mid-Aged and Older Adult: A Population-Based Cross-Sectional Study
Authors: Zhang Lin , Yang Liu , Wang Congzhi , Yuan Ting , Zhang Dongmei , Wei Huanhuan , Li Jing , Lei Yunxiao , Sun Lu , Li Xiaoping , Hua Ying , Che Hengying , Li Yuanzhen , Liu Haiyang 
Published: September 2021

Abstract
Background: Undernutrition in early life may have a lifelong effect on adult health. The associations between undernutrition and obesity parameters and dyslipidemia were inconsistent. The present study aimed to investigate the individual and combined effects of famine exposure and obesity parameters on dyslipidemia in middle-aged and older Chinese.Method: Data were selected from the China Health and Retirement Longitudinal Study Wave2011. The analytic sample included 9427 subjects aged 45 to 90. The present study analyzed data from 9427 middle-aged and older Chinese selected from the China Health and Retirement Longitudinal Study (CHARLS Wave2011). Differences between baseline characteristics and famine exposure/BMI levels/WC levels were evaluated using the Chi-square test, t-test, and F-test. Then, the difference in the prevalence of dyslipidemia between characteristic groups was also estimated by the Chi-square and t-test. Finally, multivariable-adjusted logistic regression models examined associations of famine exposure and obesity parameters with odds of prevalence of dyslipidemia.Results: Among the 9427 participants, 1097(11.64%) participants had been exposed to the Chinese famine during the fetal stage, whereas 3763(39.92%) participants and 3251(34.49%) participants had been exposed to the famine during childhood and adolescence/adult stage, respectively. Regarding the participants with BMI measurements,2771(29.39%) were overweight and 1105(11.72%) were obese, whereas 3955(41.95%) of the participants with WC measurements were obese, respectively. Furthermore, 1899(43.23%) reported having dyslipidemia in males and 1860(36.95%) in females. In multivariable-adjusted model, famine exposure and obesity parameters were associated with prevalence of dyslipidemia independently in total populations[(1) Model three c, famine exposure with prevalence of dyslipidemia: the fatal exposed vs no exposed group, 1.32 (95% CI 1.12, 1.56); childhood-exposed vs no exposed group, 1.49 (95% CI 1.30, 1.70); the adolescence/adult-exposed vs no exposed group, 1.49 (95%CI 1.30, 1.71) ; P for trend=0.000; (2) Model three e, famine exposure with prevalence of dyslipidemia: the fatal exposed vs no exposed group, 1.29 (95% CI 1 .09, 1.52); childhood-exposed vs no exposed group, 1.39 (95% CI 1.22, 1.59); the adolescence/adult-exposed vs no exposed group, 1.27 (95%CI 1.11, 1.46) ; P for trend=0.002; (3) Model three g, BMI levels with prevalence of dyslipidemia: overweight vs normal, 2.06 (95%CI 1.86, 2.27); obesity vs normal, 2.82(95% CI 2.42, 3.27); P for trend=0.000; (4) WC levels with prevalence of dyslipidemia: overweight vs normal, 2.24 (95% CI 2.05, 2.45)]. When stratified by sex, the results in females were mostly similar to those in the total population. In a multivariable logistic regression model three c, associations between famine exposure and dyslipidemia were not observed [fatal exposed group vs non-exposed group: 0.98 (95% CI 0.75, 1.28); childhood-exposed group vs non-exposed group: 0.96 (95% CI 0.78, 1.19); adolescence/adult exposed group vs non-exposed group: 0.86 (95% CI 0.69, 1.07)] independently of BMI only (P for trend =0.110). However, in a multivariable logistic regression model three e, associations between famine exposure and dyslipidemia in male were partly observed [fatal exposed group vs non-exposed group: 0.97 (95% CI 0.74, 1.26); childhood-exposed group vs non-exposed group: 0.91 (95% CI 0.74, 1.13); adolescence/adult exposed group vs non-exposed group: 0.73 (95% CI 0.59, 0.91)] independently of BMI only (P for trend =0.001). In general, the significant synergism between famine exposure and obesity parameters in lowering the prevalence of dyslipidemia was observed in males while the significant synergism in increasing prevalence of dyslipidemia was observed in females (P-interaction =0.000).Conclusion: Individual and combined associations of obesity parameters and famine exposure with the prevalence of dyslipidemia were observed in middle-aged and elderly Chinese.