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Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period.
Int J Epidemiol 2014; 43(6):1806-14IJ

Abstract

BACKGROUND

Animal models have suggested that undernutrition during gestation and the early postnatal period may adversely affect kidney development and compromise renal function. As a natural experiment, famines provide an opportunity to test such potential effects in humans. We assessed whether exposure to the Chinese famine of 1959-1961 during gestation and early postnatal life was associated with the levels of proteinuria among female adults three decades after exposure to the famine.

METHODS

We measured famine intensity using the cohort size shrinkage index and we constructed a difference-in-difference model to compare the levels of proteinuria, measured with a dipstick test of random urine specimens, among Chinese women (n = 70 543) whose exposure status to the famine varied across birth cohorts (born before, during or after the famine) and counties of residence with different degrees of famine intensity.

RESULTS

Famine exposure was associated with a greater risk [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.04, 2.28; P = 0.029) of having higher level of proteinuria among women born during the famine years (1959-61) compared with the unexposed post famine-born cohort (1964-65) in rural samples. No association was observed among urban samples. Results were robust to adjustment for covariates.

CONCLUSIONS

Severe undernutrition during gestation and the early postnatal period may have long-term effects on levels of proteinuria in humans, but the effect sizes may be small.

Authors+Show Affiliations

George Washington University - Department of Global Health, Washington, District of Columbia, United States, UC Berkeley School of Public Health - Health Services & Policy Analysis, Berkeley, California, United States, University of Maryland School of Public Health, College Park, Maryland, United States and Emory University - Hubert Department of Global Health, Atlanta, Georgia, United States chenghuang@gwu.edu.George Washington University - Department of Global Health, Washington, District of Columbia, United States, UC Berkeley School of Public Health - Health Services & Policy Analysis, Berkeley, California, United States, University of Maryland School of Public Health, College Park, Maryland, United States and Emory University - Hubert Department of Global Health, Atlanta, Georgia, United States.George Washington University - Department of Global Health, Washington, District of Columbia, United States, UC Berkeley School of Public Health - Health Services & Policy Analysis, Berkeley, California, United States, University of Maryland School of Public Health, College Park, Maryland, United States and Emory University - Hubert Department of Global Health, Atlanta, Georgia, United States.George Washington University - Department of Global Health, Washington, District of Columbia, United States, UC Berkeley School of Public Health - Health Services & Policy Analysis, Berkeley, California, United States, University of Maryland School of Public Health, College Park, Maryland, United States and Emory University - Hubert Department of Global Health, Atlanta, Georgia, United States.George Washington University - Department of Global Health, Washington, District of Columbia, United States, UC Berkeley School of Public Health - Health Services & Policy Analysis, Berkeley, California, United States, University of Maryland School of Public Health, College Park, Maryland, United States and Emory University - Hubert Department of Global Health, Atlanta, Georgia, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25298393

Citation

Huang, Cheng, et al. "Elevated Levels of Protein in Urine in Adulthood After Exposure to the Chinese Famine of 1959-61 During Gestation and the Early Postnatal Period." International Journal of Epidemiology, vol. 43, no. 6, 2014, pp. 1806-14.
Huang C, Guo C, Nichols C, et al. Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period. Int J Epidemiol. 2014;43(6):1806-14.
Huang, C., Guo, C., Nichols, C., Chen, S., & Martorell, R. (2014). Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period. International Journal of Epidemiology, 43(6), pp. 1806-14. doi:10.1093/ije/dyu193.
Huang C, et al. Elevated Levels of Protein in Urine in Adulthood After Exposure to the Chinese Famine of 1959-61 During Gestation and the Early Postnatal Period. Int J Epidemiol. 2014;43(6):1806-14. PubMed PMID: 25298393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period. AU - Huang,Cheng, AU - Guo,Chaoran, AU - Nichols,Catherine, AU - Chen,Shuo, AU - Martorell,Reynaldo, Y1 - 2014/10/08/ PY - 2014/10/10/entrez PY - 2014/10/10/pubmed PY - 2015/9/10/medline KW - Barker hypothesis KW - famine KW - maternal undernutrition KW - natural experiment KW - proteinuria KW - renal function SP - 1806 EP - 14 JF - International journal of epidemiology JO - Int J Epidemiol VL - 43 IS - 6 N2 - BACKGROUND: Animal models have suggested that undernutrition during gestation and the early postnatal period may adversely affect kidney development and compromise renal function. As a natural experiment, famines provide an opportunity to test such potential effects in humans. We assessed whether exposure to the Chinese famine of 1959-1961 during gestation and early postnatal life was associated with the levels of proteinuria among female adults three decades after exposure to the famine. METHODS: We measured famine intensity using the cohort size shrinkage index and we constructed a difference-in-difference model to compare the levels of proteinuria, measured with a dipstick test of random urine specimens, among Chinese women (n = 70 543) whose exposure status to the famine varied across birth cohorts (born before, during or after the famine) and counties of residence with different degrees of famine intensity. RESULTS: Famine exposure was associated with a greater risk [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.04, 2.28; P = 0.029) of having higher level of proteinuria among women born during the famine years (1959-61) compared with the unexposed post famine-born cohort (1964-65) in rural samples. No association was observed among urban samples. Results were robust to adjustment for covariates. CONCLUSIONS: Severe undernutrition during gestation and the early postnatal period may have long-term effects on levels of proteinuria in humans, but the effect sizes may be small. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/25298393/Elevated_levels_of_protein_in_urine_in_adulthood_after_exposure_to_the_Chinese_famine_of_1959_61_during_gestation_and_the_early_postnatal_period_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyu193 DB - PRIME DP - Unbound Medicine ER -