IJE Advance Access originally published online on November 26, 2004
International Journal of Epidemiology 2004 33(6):1219-1226; doi:10.1093/ije/dyh221
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IJE vol.33 no.6 © International Epidemiological Association 2004; all rights reserved.
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Childhood migration and cardiovascular risk
1 Department of Community Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Correspondence: Dr Gabriel M Leung, Department of Community Medicine, 5/F Academic and Administrative Block, Faculty of Medicine Building, University of Hong Kong, 21 Sassoon Road, Hong Kong Special Administrative Region, China. E-mail: gmleung{at}hku.hk
Background Childhood living conditions have been hypothesized to be associated with the development of cardiovascular diseases and diabetes mellitus in adult life.
Methods We analysed, using logistic regression, the risk of self-reported diabetes, hypertension, hyperlipidaemia, and ischaemic heart disease in a population-based sample of 3643 Chinese men and 3778 Chinese women some of whom had experienced a change to more favourable economic conditions at different life stages through migration from mainland China to Hong Kong.
Results Adjusting for socio-economic status, risk behaviours, and family history, the development of diabetes was associated with migration from China to Hong Kong in the first two decades of life, albeit with a decreasing intensity of effect (OR = 2.02, 95% CI: 1.18, 3.45, OR = 1.84, 95% CI: 1.27, 2.66, and OR = 1.72, 95% CI: 1.21, 2.45 for migration at ages 0–7, 8–17, and 18–24, respectively). The development of hypertension was mostly susceptible to environmental change during the growth spurt and puberty (migration at ages 8–17 OR = 1.56, 95% CI: 1.22, 1.99). The development of heart disease was associated with a sex-specific critical period in early childhood for men (migration at ages 0–7 OR = 3.17, 95% CI: 1.70, 5.91).
Conclusion Environmental change by migration throughout the first two decades of life can affect the development of diabetes, hypertension, hyperlipidaemia, and ischaemic heart disease, although adverse childhood conditions alone may not be a risk factor. Our results suggest that specific life course pathways may pre-dispose to these conditions and could be relevant to their aetiology in populations undergoing rapid development.
Keywords Life course epidemiology, economic conditions, cardiovascular disease, diabetes mellitus, hypertension, migration
Accepted 2 April 2004
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