Early life exposure to famine and risk of dyslipidemia in adults: a systematic review and Meta-analysis

Background Dyslipidemia is the major contributor to the global disease burden. Earlier epidemiologic research has linked early-life famine exposure to dyslipidemia and altered lipid profiles in adulthood, but a uniform perspective has yet to be established. In response, this systematic review and meta-analysis is aimed to investigate the association of early life famine exposure and dyslipidemia in adults. Methods Scopus, Medline and Google scholar databases were searched for articles published until October 2020. Studies of famine exposure during prenatal and early postnatal life and their association with dyslipidemia and lipid profiles in adults were included. Random effect model in the Meta-analysis and Mantel- Haenszel model was used to calculate odds ratios and their 95% confidence intervals to evaluate the strength of association between famine exposure and dyslipidemia. The lipid profiles of the exposed and non-exposed groups were compared using the standardized mean difference (SMD). Heterogeneity between studies were assessed using I-2 values. Results We identified 17 studies for assessing the association between early life famine exposure and risk of dyslipidemia in adults. About 11 studies were included for meta-analysis. Prenatal exposure to famine was associated with increased risk of dyslipidemia [OR = 1.74 (95% CI: 1.31, 2.31)], total cholesterol [SMD = 2.07 (95% CI: 1.40, 2.74)], LDL-cholesterol [SMD = 1.16 (95% CI: 0.25, 0.26)] and decreased HDL-cholesterol [SMD = -0.05 (95% CI: -0.10, -0.01)]. Likewise, famine exposure during early postnatal period was associated with increased risk of total cholesterol [SMD = 0.18 (95% CI: 0.11, 0.25), I-2 = 29%] and LDL-cholesterol [SMD = 0.15 (95% CI: 0.07, 0.23), I-2 = 61%]. Conclusions Famine exposure in early life was found to have an association with increased risk of dyslipidemia and altered lipide profile during adulthood. Our findings highlight the need for promoting better nutrition during pregnancy and infancy to prevent dyslipidemia during adulthood.