Early Life Exposure to the Great Chinese Famine and Cardiometabolic Outcomes
Notice bibliographique
Résumé
Importance: Epidemiologic studies suggest that people who were exposed to famine during early life but now live in nutrient-abundant environments have an elevated risk of type 2 diabetes (T2D) and other cardiometabolic conditions. Although many individuals who were exposed to famine in early life have now immigrated to high-income countries, the association between early life famine exposure and cardiometabolic outcomes among immigrants is unknown. Objective: To investigate the associations of early life exposure to the Great Chinese Famine with the incidence of T2D, hypertension, and cardiovascular hospitalization among immigrants. Design, Setting, and Participants: This population-based cohort study in Ontario, Canada, used 3 cohorts (1 for each coprimary outcome of T2D, hypertension, and cardiovascular hospitalization) of adult Chinese immigrants aged 20 to 85 years living in Ontario from April 1, 1992, to March 31, 2019. Participants were followed up until 85 years of age, relocation from Ontario, or March 31, 2023 (whichever occurred first). Data were analyzed from April 22, 2024, to September 30, 2025. Exposure: Prenatal, childhood, and adolescent exposure to famine, classified by year of birth (1941-1952). Those born before 1941 or after 1962 served as the comparison group. Main Outcomes and Measures: Incident T2D, hypertension, and cardiovascular hospitalization were the coprimary outcomes. Results: The T2D cohort included 188 292 individuals (exposed: mean [SD] age, 52.6 [10.8] years; 53.3% female; unexposed: mean [SD] age, 37.4 [12.5] years; 54.9% female), the hypertension cohort included 180 510 individuals (exposed: mean [SD] age, 51.8 [10.6] years; 52.3% female; unexposed: mean [SD] age, 36.6 [11.5] years; 55.0% female), and the cardiovascular hospitalization cohort included 208 921 individuals (exposed: mean [SD] age, 50.5 [12.0] years; 51.5% female; comparison: mean [SD] age, 37.8 [13.1] years; 54.6% female). Event rates among the famine-exposed group were 13.6% for T2D, 29.8% for hypertension, and 1.6% for cardiovascular hospitalization. Early life famine exposure was associated with increased hazards of T2D (prenatal: hazard ratio [HR], 1.58 [95% CI, 1.49-1.68]; childhood: HR, 1.45 [95% CI, 1.38-1.54]; adolescent: HR, 1.37 [95% CI, 1.28-1.46]) and hypertension (prenatal: HR, 1.22 [95% CI, 1.17-1.27]; childhood: HR, 1.25 [95% CI, 1.21-1.30]; adolescent: HR, 1.25 [95% CI, 1.20-1.31]). Prenatal and childhood exposure to famine were not associated with risk of cardiovascular hospitalization (prenatal: HR, 0.92 [95% CI, 0.76-1.12]; childhood: HR, 0.98 [95% CI, 0.86-1.11]), but adolescent exposure to famine was associated with a 14% decrease in risk of cardiovascular hospitalization (HR, 0.86 [95% CI, 0.75-0.98]). Conclusions and Relevance: In this cohort study of Chinese immigrants, early life famine exposure was strongly associated with increased risks of incident T2D and hypertension, but not cardiovascular hospitalization. Early life undernutrition is a novel cardiometabolic risk factor among immigrants associated with the burden of T2D and hypertension in high-income countries.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».