Sex-specific relationships between adverse childhood experiences and chronic obstructive pulmonary disease in five states
Sex-specific relationships between adverse childhood experiences and chronic obstructive pulmonary disease in five states
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DOI：
10.2147/copd.s68226
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发表时间：
2014-01-01
影响因子：
2.8
通讯作者：
Giles, Wayne H.
中科院分区：
文献类型：
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作者：
Cunningham, Timothy J.;Ford, Earl S.;Giles, Wayne H.
目的：18岁以前的不良童年经历(ACE)在成年后反复与多种慢性疾病有关，如抑郁症、心脏病、癌症、糖尿病和中风。材料和方法：对2011年行为危险因素监测系统中5个州的26,546名女性和19,015名男性的数据进行了分析。在调整了年龄组、种族/民族、婚姻状况、教育程度、就业、哮喘史、医疗保险覆盖范围和吸烟状况后，我们使用对数线性回归估计了8种ACE与COPD关系的患病率(PR)及其相应的95%可信区间(CI)。结果：约63.8%的女性和62.2%的男性报告&>>=1。报告COPD的女性比例为4.9%，男性比例为4.0%。在女性中，与言语虐待(PR=1.30，95%CI：1.05，1.61)、性虐待(PR=1.69，95%CI：1.36，2.10)、与滥用药物的家庭成员生活在一起(PR=1.49，95%CI：1.23，1.81)、经历家庭暴力(PR=1.40，95%CI：1.14，1.72)、父母分居/离婚(PR=1.47，95%CI：1.21，1.80)与那些没有单独的A的人相比。报告5个ACE(PR=2.08，95%CI：1.55，2.80)与无ACE相比，仅在女性中患COPD的可能性更高。结论：ACE与COPD有关，尤其是在女性中。这些发现强调了进一步研究的必要性，以检查特定性别的差异以及将ACE与COPD联系起来的可能机制。这项工作增加了越来越多的研究，表明ACE可能会导致晚年的健康问题，并建议需要计划和政策解决方案。
Purpose: Adverse childhood experiences (ACEs) before age 18 have been repeatedly associated with several chronic diseases in adulthood such as depression, heart disease, cancer, diabetes, and stroke. We examined sex-specific relationships between individual ACEs and the number of ACEs with chronic obstructive pulmonary disease (COPD) in the general population.Materials and methods: Data from 26,546 women and 19,015 men aged >= 18 years in five states of the 2011 Behavioral Risk Factor Surveillance System were analyzed. We used log-linear regression to estimate prevalence ratios (PRs) and their corresponding 95% confidence intervals (CIs) for the relationship of eight ACEs with COPD after adjustment for age group, race/ethnicity, marital status, educational attainment, employment, asthma history, health insurance coverage, and smoking status.Results: Some 63.8% of women and 62.2% of men reported >= 1 ACE. COPD was reported by 4.9% of women and 4.0% of men. In women, but not in men, there was a higher likelihood of COPD associated with verbal abuse (PR = 1.30, 95% CI: 1.05, 1.61), sexual abuse (PR = 1.69, 95% CI: 1.36, 2.10), living with a substance abusing household member (PR = 1.49, 95% CI: 1.23, 1.81), witnessing domestic violence (PR = 1.40, 95% CI: 1.14, 1.72), and parental separation/divorce (PR = 1.47, 95% CI: 1.21, 1.80) during childhood compared to those with no individual ACEs. Reporting >= 5 ACEs (PR = 2.08, 95% CI: 1.55, 2.80) compared to none was associated with a higher likelihood of COPD among women only.Conclusion: ACEs are related to COPD, especially among women. These findings underscore the need for further research that examines sex-specific differences and the possible mechanisms linking ACEs and COPD. This work adds to a growing body of research suggesting that ACEs may contribute to health problems later in life and suggesting a need for program and policy solutions.