Economic Status Moderates the Association Between Early-Life Famine Exposure and Hyperuricemia in Adulthood

Context: The double burden of malnutrition (DBM), undernutrition in early life and an obesogenic environment later on, influences later risk of chronic disorders. The Great Famine in China from 1959 to1962 and remarkable economic development from the 1980s provided such a burden for a large number of people in their 60s. Objective: We aimed to analyze the effect of economic status on the association between famine exposure in early life and hyperuricemia in adulthood. Design and Setting: Participants numbering 12 666 were enrolled in China based on the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Study from 2014 to 2016. Participants: Participants with fetal or childhood famine exposure (birth year 1949-1962) formed the exposure group. Main Outcome Measure: Hyperuricemia was defined as uric acid (UA) > 420 mu mol/L for men and > 360 mu mol/L for women. The association of famine with hyperuricemia was assessed via regression analyses. Results: Early-life famine exposure was negatively associated with UA levels (P = .045) but was not associated with hyperuricemia (P= .226) in the whole study population. Economic status could moderate the association of famine exposure with UA and hyperuricemia (P <= .001). In participants with high economic status, early-life famine exposure was positively associated with UA levels (unstandardized coefficients 7.61, 95% CI 3.63-11.59, P< .001), and with hyperuricemia (odds ratio 1.47, 95% CI 1.19-1.81, P< .001). Conclusions: Economic status could moderate the association between exposure to famine in early life and hyperuricemia in adulthood, indicating that the DBM might affect hyperuricemia in an opposite direction of the effects of undernutrition in early life alone.