The relationship between famine exposure during early life and ascending aorta dilatation in adults

Background and aims: The relationship between exposure to famine in early life and the risk of ascending aorta dilatation (AAD) in adulthood is still unclear, therefore we aimed to examine the association in a Chinese population. Methods and results: We investigated the data of 2,598 adults that were born between 1,952 and 1,964 in Guangdong, China. All enrolled subjects were categorized into five groups: not exposed to famine, exposed during fetal period, and exposed during early, mid or late childhood. AAD was assessed by cardiac ultrasound. Multivariate logistic regression and interaction tests were performed to estimate the odds ratio (OR) and confidence interval (CI) on the association between famine exposure and AAD. There were 2,598 (943 male, mean age 58.3 ± 3.68 years) participants were enrolled, and 270 (10.4%) subjects with AAD. We found that famine exposure (OR=2.266, 95% CI: 1.477, 3.477, P=0.013) associated with elevated AAD after adjusting for multiple confounders. In addition, compared with the non-exposure group, the adjusted ORs for famine exposure during fetal period, early, mid or late childhood were 1.374 (95% CI: 0.794, 2.364, P=0.251), 1.976 (95% CI: 1.243, 3.181, P=0.004), 1.929 (95% CI: 1.237, 3.058, P=0.004) and 2.227 (95% CI: 1.433, 3.524, P<0.001), respectively. Subgroup analysis showed that the effect of famine exposure on the association with AAD was more pronounced in female, current smokers, people with BMI ≥24 kg/m ² and hypertensive patients. Conclusion: We observed that exposure to famine during early life was linked to AAD in adulthood.