Childhood maltreatment and obesity: systematic review and meta-analysis
Childhood maltreatment and obesity: systematic review and meta-analysis
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DOI：
10.1038/mp.2013.54
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发表时间：
2014-05-01
影响因子：
11
通讯作者：
Tan, M.
中科院分区：
文献类型：
--
作者：
Danese, A.;Tan, M.
肥胖是一个普遍存在的全球健康问题，与大量的发病率、损伤和经济负担相关。由于大多数现成的治疗形式从长远来看是无效的，因此通过识别潜在的可改变的危险因素来提高肥胖预防知识至关重要。非人类灵长类动物的实验研究结果表明，不良的童年经历可能会影响肥胖风险。然而，人类研究的观察显示出不同的结果。为了解决这些不一致问题，我们在 Medline、PsycInfo 和 Embase 上进行了截至 2012 年 8 月 1 日的搜索，寻找研究儿童虐待与肥胖之间关联的文章。然后，我们对已确定的研究进行了荟萃分析，并探讨了各种可能的偏差来源的影响。对 41 项研究（190 285 名参与者）的荟萃分析显示，儿童期虐待与一生中患肥胖症的风险升高相关（比值比 = 1.36；95% 置信区间 = 1.26-1.47）。结果不能用发表偏倚或个别研究的不当影响来解释。总体而言，结果并未受到虐待或肥胖所使用的测量或定义的显着影响，也没有受到儿童或成人社会经济状况、当前吸烟、饮酒或体力活动的混杂因素的显着影响。然而，在针对儿童和青少年的研究中，这种关联并不具有统计学意义，这些研究侧重于情感忽视或针对当前抑郁症的调整。此外，在包含更多女性和白人的样本中，这种关联性更强，但不受研究质量的影响。虐待儿童是肥胖的一个潜在可改变的危险因素。未来的研究应该阐明虐待儿童影响肥胖风险的机制，并探索补救这种影响的方法。
Obesity is a prevalent global-health problem associated with substantial morbidity, impairment and economic burden. Because most readily available forms of treatment are ineffective in the long term, it is essential to advance knowledge of obesity prevention by identifying potentially modifiable risk factors. Findings from experimental studies in non-human primates suggest that adverse childhood experiences may influence obesity risk. However, observations from human studies showed heterogeneous results. To address these inconsistencies, we performed Medline, PsycInfo and Embase searches till 1 August 2012 for articles examining the association between childhood maltreatment and obesity. We then conducted a meta-analysis of the identified studies and explored the effects of various possible sources of bias. A meta-analysis of 41 studies (190 285 participants) revealed that childhood maltreatment was associated with elevated risk of developing obesity over the life-course (odds ratio = 1.36; 95% confidence interval = 1.26-1.47). Results were not explained by publication bias or undue influence of individual studies. Overall, results were not significantly affected by the measures or definitions used for maltreatment or obesity, nor by confounding by childhood or adult socioeconomic status, current smoking, alcohol intake or physical activity. However, the association was not statistically significant in studies of children and adolescents, focusing on emotional neglect, or adjusting for current depression. Furthermore, the association was stronger in samples including more women and whites, but was not influenced by study quality. Child maltreatment is a potentially modifiable risk factor for obesity. Future research should clarify the mechanisms through which child maltreatment affects obesity risk and explore methods to remediate this effect.