Abstract：
Malnutrition in early life increases the risk of osteoporosis, but the association of early-life undernutrition combined with adulthood obesity patterns with low-energy fracture remains unknown. This study included 5323 community-dwelling subjects aged ⩾40 years from China. Early-life famine exposure was identified based on the participants\' birth dates. General obesity was assessed using the body mass index (BMI), and abdominal obesity was evaluated with the waist-to-hip ratio (WHR). Low-energy fracture was defined as fracture occurring after the age of ⩾40 typically caused by falls from standing height or lower. Compared to the nonexposed group, the group with fetal, childhood, and adolescence famine exposure was associated with an increased risk of fracture in women with odds ratios (ORs) and 95% confidence intervals (CIs) of 3.55 (1.57-8.05), 3.90 (1.57-9.71), and 3.53 (1.05-11.88), respectively, but not in men. Significant interactions were observed between fetal famine exposure and general obesity with fracture among women (P for interaction = 0.0008). Furthermore, compared with the groups with normal BMI and WHR, the group of women who underwent fetal famine exposure and had both general and abdominal obesity had the highest risk of fracture (OR, 95% CI: 3.32, 1.17-9.40). These results indicate that early-life famine exposure interacts with adulthood general obesity and significantly increases the risk of low-energy fracture later in life in women.
摘要：
早期营养不良会增加骨质疏松症的风险，但早年营养不足与成年期肥胖模式与低能量骨折之间的关系尚不清楚.这项研究包括5323名来自中国的40岁社区居民。早期饥荒暴露是根据参与者的出生日期确定的。使用体重指数（BMI）评估一般肥胖，用腰臀比(WHR)评估腹型肥胖.低能量骨折被定义为40岁以后发生的骨折，通常是由站立高度或更低高度的跌倒引起的。与非暴露组相比，有胎儿的群体，童年,青春期饥荒暴露与优势比（ORs）和95％置信区间（CIs）为3.55（1.57-8.05）的女性骨折风险增加有关，3.90(1.57-9.71),和3.53（1.05-11.88），分别,但不是男人。在女性中，胎儿饥荒暴露与全身肥胖伴骨折之间观察到显著的相互作用（相互作用的P=0.0008）。此外，与BMI和WHR正常的组相比，暴露于胎儿饥荒并同时患有全身和腹部肥胖的女性组骨折风险最高(OR，95%CI：3.32，1.17-9.40）。这些结果表明，早期饥荒暴露与成年期一般肥胖相互作用，并显着增加了女性晚年低能量骨折的风险。
