Obesity and type 2 diabetes risk in midadult life:: The role of childhood adversity
Obesity and type 2 diabetes risk in midadult life:: The role of childhood adversity
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DOI：
10.1542/peds.2007-2403
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发表时间：
2008-05-01
期刊：
影响因子：
8
通讯作者：
Power, Chris
中科院分区：
文献类型：
--
作者：
Thomas, Claudia;Hyppoenen, Elina;Power, Chris
OBJECTIVE.虐待儿童与成年后身体健康状况较差有关，但对更广泛的儿童逆境知之甚少，包括忽视和家庭问题，或从逆境到成人疾病的途径。我们已经研究了不同的压力情绪或忽视童年逆境是如何与肥胖和葡萄糖控制在中年，考虑到儿童的因素，以及是否成年健康行为和社会经济地位介导的关系。这是一项前瞻性纵向研究，9310名成员的1958年英国出生队列谁参加了生物医学采访在45岁。主要结果包括45岁时连续测量的BMI、腰围和糖化血红蛋白以及分类指标：总肥胖（BMI >= 30）、中心性肥胖（腰围：男性>= 102 cm，女性>= 88 cm）和糖化血红蛋白水平>= 6。肥胖的风险增加了20%至50%的几个逆境（身体虐待，言语虐待，目睹虐待，羞辱，忽视，严格的教养，体罚，冲突或紧张，父母对教育的期望或兴趣低，几乎不带父母外出，父亲几乎不给孩子读书）。与肥胖相关性最强（如身体虐待）的儿童往往与糖化血红蛋白水平>= 6相关，但在大多数情况下，相关性是通过调整成人介质（如肥胖）来解释的。其他反映不太严重的情感忽视和家庭环境的不利因素的影响在很大程度上是由儿童的社会经济因素解释的。一些儿童时期的逆境会增加成年后肥胖的风险，从而增加患2型糖尿病的风险。需要进行研究，以了解逆境的相互关联性，其发生的社会背景，以及从逆境到成人疾病的轨迹。
OBJECTIVE. Child abuse has been associated with poorer physical health in adulthood, but less is known about childhood adversity more broadly, including neglect and family problems, or the pathways from adversity to adult disease. We have examined how different stressful emotional or neglectful childhood adversities are related to adiposity and glucose control in midadulthood, taking into account childhood factors, and whether the relationships are mediated by adult health behaviors and socioeconomic position.METHODS. This was a prospective longitudinal study of 9310 members of the 1958 British birth cohort who participated in a biomedical interview at 45 years of age. Primary outcomes consisted of continuous measures of BMI, waist circumference, and glycosylated hemoglobin at 45 years and categorical indicators: total obesity (BMI >= 30), central obesity (waist circumference: >= 102 cm for men and >= 88 cm for women), and glycosylated hemoglobin level of >= 6.RESULTS. The risk of obesity increased by 20% to 50% for several adversities (physical abuse, verbal abuse, witnessed abuse, humiliation, neglect, strict upbringing, physical punishment, conflict or tension, low parental aspirations or interest in education, hardly takes outings with parents, and father hardly reads to child). Adversities with the strongest associations with adiposity (eg, physical abuse) tended to be associated with glycosylated hemoglobin levels of >= 6, but in most cases associations were explained by adjustment for adulthood mediators such as adiposity. Effects of other adversities reflecting less severe emotional neglect and family environment were largely explained by childhood socioeconomic factors.CONCLUSIONS. Some childhood adversities increase the risk of obesity in adulthood and thereby increase the risk for type 2 diabetes. Research is needed to understand the interrelatedness of adversities, the social context of their occurrence, and trajectories from adversity to adult disease.