Social-economic inequalities and early-life exposure to famine contribute to low grip strength: The China National Health Survey

Huijing He; Li Pan; Dingming Wang; Feng Liu; Jianwei Du; Lize Pa; Xianghua Wang; Ze Cui; Xiaolan Ren; Hailing Wang; Xia Peng; Jingbo Zhao; Guangliang Shan

doi:10.1016/j.numecd.2024.103842

Social-economic inequalities and early-life exposure to famine contribute to low grip strength: The China National Health Survey

Nutr Metab Cardiovasc Dis. 2024 Dec 25:103842. doi: 10.1016/j.numecd.2024.103842. Online ahead of print.

Authors

Huijing He¹, Li Pan¹, Dingming Wang², Feng Liu³, Jianwei Du⁴, Lize Pa⁵, Xianghua Wang⁶, Ze Cui⁷, Xiaolan Ren⁸, Hailing Wang⁹, Xia Peng¹⁰, Jingbo Zhao¹¹, Guangliang Shan¹²

Affiliations

¹ Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China.
² Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China.
³ Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China.
⁴ Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China.
⁵ Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China.
⁶ Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China.
⁷ Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China.
⁸ Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China.
⁹ Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China.
¹⁰ Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China.
¹¹ Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China.
¹² Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China. Electronic address: guangliang_shan@163.com.

PMID: 39765377
DOI: 10.1016/j.numecd.2024.103842

Abstract

Background and aim: The relationship between socio-economic inequalities (SEIs) and early life malnutrition with muscle health remains unclear. This study aims to examine the effects of SEIs and early life exposure to famine on relative hand grip strength (rHGS).

Methods and results: We analyzed data of 37,008 individuals from the China National Health Survey. SEI were assessed using the Population Attributable Fraction (PAF), the Relative Index of Inequality (RII), and the Slope Index of Inequality (SII). The propensity score matching and cohort size shrinkage index were used to examine the impact of famine on low rHGS. The RII for education- and income-based SEI was 1.17 (95 % CI: 1.09 to 1.27) and 1.20 (95 % CI: 1.11 to 1.29) in men, and 1.20 (95 % CI: 1.12 to 1.28) and 1.06 (95 % CI: 0.99 to 1.13) in women, respectively. The SII per 100,000 persons for education- and income-based SES was 609 (207-1011) and 912 (481-1343) in men, compared to 909 (580-1237) and 218 (-134 to 570) in women. The stimulation analysis showed that both RII and SII increased with a higher proportion of individuals at the highest income level, exhibiting a sex-differential pattern. Early-life exposure to famine was significantly associated with decreased rHGS. The PAFs of low rHGS attributed to famine ranged from 2.5 % to 4.6 % in men and 5.8 %-9.6 % in women.

Conclusions: SEI and early life malnutrition increased the risk of low rHGS. These findings are valuable for informing policymaking aimed at healthy aging.

Keywords: Hand grip strength; Malnutrition; Muscle health; Population attributable fraction; Sarcopenia; Social-economic inequality.

Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.