Exposure to famine during early life and the risk of MAFLD during adulthood: evidence from the China Multi-Ethnic Cohort (CMEC) study

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease, affecting nearly one-third of the global population. The relationship between early-life famine exposure and MAFLD remains unclear in the multiethnic region of less-developed southwest China.A total of 18 558 participants who came from the baseline survey of the China Multi-Ethnic Cohort Study in Yunnan were included. Participants were divided into four groups according to birth year, including non-exposed (1962–1978 and 1939–1943), fetal exposed (1959–1961), childhood exposed (1949–1958) and adolescence exposed (1943–1949). Logistic regression analysis was used to explore the relationship between famine exposure in early life and the risk of MAFLD in adulthood.Experiencing the shock of early-life exposure to famine would affect adulthood MAFLD. Exposure to famine during fetal life and childhood increased the risk of MAFLD in adulthood, with this association being particularly pronounced in Bai populations. Moreover, famine exposure in males during fetal life raised the risk of MAFLD in adulthood.We suggest that adequate nutrition in early life may be beneficial in preventing MAFLD in adulthood. The prevention of chronic liver disease should adopt a whole-life strategy by extending the prevention window beginning from fetal life.