Abstract
Objective
The risk of metabolic disease in adulthood is not only attributed to an unhealthy
lifestyle after birth but also to famine exposure during the foetal period. This systematic
review and meta-analysis aimed to evaluate the effects of foetal exposure to famine
as a risk factor for developing nonalcoholic fatty liver disease (NAFLD) in adulthood.
Methods
Studies were retrieved from PubMed, Embase, Cochrane Library, Web of Science, China
National Knowledge Infrastructure (CNKI), and Wanfang databases to evaluate the effect
of foetal exposure to famine on the risk of nonalcoholic fatty liver disease in adulthood.
Results
Six studies involving 90,582 subjects were included in this meta-analysis. Foetal
exposure to famine was associated with an increased risk of NAFLD(RR = 1.17, 95% CI:
1.08–1.27, P < 0.0001). Exposure to famine during the foetal period significantly increased the
incidence of NAFLD in women (RR = 1.27, 95% CI: 1.16–1.40, P <0.00001), while similar results were not observed in the male subgroup (RR =0.99,
95% CI: 0.89–1.11, P = 0.88). Foetal exposure to famine was associated with the risk of mild NAFLD (RR = 1.17,
95% CI: 1.02–1.33, P = 0.02) and moderate to severe NAFLD (RR = 1.51, 95% CI: 1.16–1.98, P = 0.002).
Conclusions
Foetal exposure to famine is associated with an increased risk of NAFLD in adulthood.
Women with NAFLD and moderate to severe NAFLD have a more robust association with
foetal exposure to famine.
Keywords
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References
- MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease.Gastroenterology. 2020; 158 (.e1): 1999-2014
- Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention.Nat Rev Gastroenterol Hepatol. 2018; 15: 11-20
- Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission.Lancet Gastroenterol Hepatol. 2020; 5: 167-228
- Epidemiology of obesity in adults: latest trends.Curr Obesity Rep. 2018; 7: 276-288
- Early developmental conditioning of later health and disease: physiology or pathophysiology?.Physiol Rev. 2014; 94: 1027-1076
- Glucose tolerance at age 58 and the decline of glucose tolerance in comparison with age 50 in people prenatally exposed to the Dutch famine.Diabetologia. 2006; 49: 637-643
- Exposure to famine during early life and abdominal obesity in adulthood: findings from the Great Chinese famine during 1959⁻1961.Nutrients. 2019; 11
- Early-life exposure to the Chinese famine, genetic susceptibility and the risk of type 2 diabetes in adulthood.Diabetologia. 2021; 64: 1766-1774
- Prenatal exposure to the Dutch famine is associated with a preference for fatty foods and a more atherogenic lipid profile.Am J Clin Nutr. 2008; 88: 1648-1652
- The famine exposure in early life and metabolic syndrome in adulthood.Clin Nutr. 2017; 36: 253-259
- Appraising the quality of medical education research methods: the Medical Education Research Study Quality Instrument and the Newcastle-Ottawa Scale-Education.Acad Med: J Assoc Am Med Coll. 2015; 90: 1067-1076
- Exacerbation of liver steatosis following exposure to famine and overnutrition.Mol Nutr Food Res. 2017; 61
- Influence of famine in women with non-alcoholic fatty liver disease.Ann Hepatol. 2017; 16: 826-827
- Foetal and childhood exposure to famine and the risks of cardiometabolic conditions in adulthood: a systematic review and meta-analysis of observational studies.Obesity Rev: Off J Int Assoc Study Obesity. 2020; 21: e12981
- Liver fattening during feast and famine: an evolutionary paradox.Med Hypotheses. 2008; 70: 924-928
- Transgenerational effects of traumatic historical events on the incidence of metabolic syndrome/nonalcoholic fatty liver disease in the Romanian population.J Med Life. 2020; 13: 475-483
- Moderation effect of economic status in the association between early life famine exposure and MAFLD in adulthood.Liver Int: Off J Int Assoc Study Liver. 2022; 42: 299-308
- Association between famine exposure in early life with insulin resistance and beta cell dysfunction in adulthood.Nutr Diabetes. 2020; 10: 18
- Exposure to the Chinese famine in early life and the thyroid function and nodules in adulthood.Endocrine Pract: Off J Am Coll Endocrinol Am Assoc Clin Endocrinol. 2019; 25: 598-604
- Exposure to famine in early life and nonalcoholic fatty liver disease in adulthood.J Clin Endocrinol Metab. 2016; 101: 2218-2225
- Early-life exposure to famine and risk of metabolic associated fatty liver disease in Chinese adults.Nutrients. 2021; 13
- Cardiometabolic traits mediated the relationship from early life famine exposure to adulthood nonalcoholic fatty liver disease risk.Br J Nutr. 2021; : 1-8
- Early life famine exposure, adulthood obesity patterns and the risk of nonalcoholic fatty liver disease.Liver Int: Off J Int Assoc Study Liver. 2020; 40: 2694-2705
- Fetal and infant exposure to the Chinese famine increases the risk of fatty liver disease in Chongqing, China.J Gastroenterol Hepatol. 2016; 31: 200-205
- The Great Chinese famine exposure in early life and the risk of nonalcoholic fatty liver disease in adult women.Ann Hepatol. 2017; 16: 901-908
- Is exposure to famine in childhood and economic development in adulthood associated with diabetes?.J Clin Endocrinol Metab. 2015; 100: 4514-4523
- Exposure to severe famine in the prenatal or postnatal period and the development of diabetes in adulthood: an observational study.Diabetologia. 2017; 60: 262-269
- Exposure to the Chinese famine in early life and the risk of hyperglycemia and type 2 diabetes in adulthood.Diabetes. 2010; 59: 2400-2406
- Early life famine exposure, ideal cardiovascular health metrics, and risk of incident diabetes: findings from the 4C study.Diabetes Care. 2020; 43: 1902-1909
- Boys live dangerously in the womb.Am J Hum Biol: Off J Hum Biol Council. 2010; 22: 330-335
- Sex specific adaptations in placental biometry of overweight and obese women.Placenta. 2016; 38: 1-7
- Sex differences in early-life programming of the hypothalamic-pituitary-adrenal axis in humans suggest increased vulnerability in females: a systematic review.J Dev Orig Health Dis. 2017; 8: 244-255
- NAFLD and NASH in postmenopausal women: implications for diagnosis and treatment.Endocrinology. 2020; 161
- Catch-up growth and metabolic outcomes in adolescents born preterm.Arch Dis Child. 2016; 101: 1026-1031
- Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children.J Clin Endocrinol Metab. 2006; 91: 2153-2158
- Maternal micronutrient deficiency, fetal development, and the risk of chronic disease.J Nutr. 2010; 140: 437-445
- Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms.Psychol Bull. 2011; 137: 959-997
- DNA methylation signatures link prenatal famine exposure to growth and metabolism.Nat Commun. 2014; 5: 5592
- Metabolic syndrome: role of maternal undernutrition and fetal programming.Rev Endocr Metab Disord. 2013; 14: 229-240
- Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions.Cochrane Database Syst Rev. 2019; 10 (Ed000142)
Article Info
Publication History
Published online: October 23, 2022
Accepted:
September 30,
2022
Received:
July 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
