Early famine exposure tied to postmenopausal osteoporosis

  • Zong L & al.
  • Endocr Pract
  • 1 Apr 2019

  • International Clinical Digest
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Takeaway

  • Famine exposure in fetal, early, and midchildhood may be associated with up to 4-fold risk for postmenopausal osteoporosis, according to a population-based cohort.

Why this matters

  • Famine may be a risk factor for osteoporosis.
  • Calcium and vitamin D supplementation may be considered for famine-exposed children.

Study design

  • Population-based cohort of 2292 participants aged ≥40 years who were born in Fujian Province, where there was a famine in 1959-1961.
  • Famine exposure was based on age.
  • Osteoporosis was measured by quantitative ultrasound (QUS), using a T-score threshold of −1.8. This threshold was selected because age-related decline in QUS measurements is almost half that seen for bone mineral density (BMD) measures performed by dual-energy X-ray absorptiometry (DEXA).
  • Funding: National Key Program of China; others.

Key results

  • Postmenopausal women with early-life famine exposure (vs unexposed) are at increased risk for osteoporosis:
    • Fetal exposed: aOR, 3.741 (P=.021).
    • Early childhood exposed: aOR, 2.894 (P=.055).
    • Midchildhood exposed: aOR, 4.699 (P=.004).
  • The prevalence of possible vertebral fracture (a loss of 2 cm height during a 3-year prospective period) was 15% among fetal-exposed, 12.9% among early-childhood-exposed, 15% among midchildhood-exposed, and 10.6% among unexposed participants.

Limitations

  • Control group not age-matched.
  • No validation of definition of osteoporosis.
  • Absence of statistics or radiographic confirmation of vertebral fracture.

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