沈阳医学院 · 辽宁 · PDF · 8 页 · 2067KB
R E S E A R C H Open Access © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y - n c - n d / 4 . 0 /. Yang and Rong BMC Public Health (2026) 26:1179 https://doi.org/10.1186/s12889-026-26461-x BMC Public Health †Qingquan Yang and Zhiyuan Rong contributed equally as corresponding authors. *Correspondence: Qingquan Yang yqqsy@163.com Zhiyuan Rong rongzhiyuan98@163.com 1The Second Affiliated Hospital of Shenyang Medical College, Shenyang 110801, China Abstract Background The aging of the global population exacerbates the burden of gastrointestinal diseases in elderly individuals. The Developmental Origins of Health and Disease (DOHaD) hypothesis suggests that early-life malnutrition may have long-lasting effects on adult health. However, evidence regarding the link between childhood famine exposure and the risk of gastrointestinal diseases in old individuals remains limited. Methods We conducted a retrospective cohort study of 4227 participants from the China Health and Retirement Longitudinal Study (CHARLS). Childhood famine exposure was defined as experiencing hunger before age 18 during the 1959–1961 famine period. The outcomes were doctor-diagnosed gastric or other digestive diseases. Logistic regression, propensity score matching (PSM), subgroup analysis, and XGBoost machine learning with SHAP explanation were used. Results A total of 83.7% of the participants had childhood famine exposure. The famine-exposed group had a significantly higher risk of gastrointestinal diseases (OR = 1.34, 95% CI: 1.12–1.61); this association persisted after PSM (OR = 1.39, 95% CI: 1.10–1.75). Subgroup analysis yielded consistent results (all P values for interactions > 0.05). Famine exposure was identified as an important predictive factor in the XGBoost machine learning algorithm. Conclusions Childhood famine exposure is significantly associated with an increased risk of gastrointestinal diseases in old individuals. This simple indicator should be included in regular health assessments for the elderly to facilitate early identification and intervention for high-risk populations. Keywords Childhood famine, Gastrointestinal diseases in the elderly, DOHaD hypothesis, CHARLS database, XGBoost Childhood famine exposure and the risk of gastrointestinal diseases in old individuals: a retrospective cohort analysis using the CHARLS database Qingquan Yang1*† and Zhiyuan Rong1*† Page 2 of 8Yang and Rong BMC Public Health (2026) 26:1179 Introduction The global population is aging at an unprecedented rate, profoundly impacting global public health systems. The number of people aged 60 and above is projected to double from approximately 1 billion in 2020 to 2.1 billion by 2050, with the majority residing in low- and middle-income countries [1]. This demographic shift has intensified the burden of age-related chronic diseases, particularly gastrointestinal disorders, which are among the most common health