Williamson D F, Thompson T J, Anda R F, Dietz W H, Felitti V
Division of Diabetes Translation, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia 30341-2717, USA.
Int J Obes Relat Metab Disord. 2002 Aug;26(8):1075-82. doi: 10.1038/sj.ijo.0802038.
Little is known about childhood factors and adult obesity. A previous study found a strong association between childhood neglect and obesity in young adults.
To estimate associations between self-reported abuse in childhood (sexual, verbal, fear of physical abuse and physical) adult body weight, and risk of obesity.
Retrospective cohort study with surveys during 1995-1997.
A total of 13,177 members of California health maintenance organization aged 19-92 y.
Body weight measured during clinical examination, followed by mailed survey to recall experiences during first 18 y of life. Estimates adjusted for adult demographic factors and health practices, and characteristics of the childhood household.
Some 66% of participants reported one or more type of abuse. Physical abuse and verbal abuse were most strongly associated with body weight and obesity. Compared with no physical abuse (55%), being 'often hit and injured' (2.5%) had a 4.0 kg (95% confidence interval: 2.4-5.6 kg) higher weight and a 1.4 (1.2-1.6) relative risk (RR) of body mass index (BMI) > or = 30. Compared with no verbal abuse (53%), being 'often verbally abused' (9.5%) had an RR of 1.9 (1.3-2.7) for BMI > or = 40. The abuse associations were not mutually independent, however, because the abuse types strongly co-occurred. Obesity risk increased with number and severity of each type of abuse. The population attributable fraction for 'any mention' of abuse (67%) was 8% (3.4-12.3%) for BMI > or = 30 and 17.3% (-1.0-32.4%) for BMI > or = 40.
Abuse in childhood is associated with adult obesity. If causal, preventing child abuse may modestly decrease adult obesity. Treatment of obese adults abused as children may benefit from identification of mechanisms that lead to maintenance of adult obesity.
关于儿童期因素与成人肥胖的情况鲜为人知。此前一项研究发现儿童期受忽视与年轻成人肥胖之间存在密切关联。
评估儿童期自我报告的虐待（性虐待、言语虐待、对身体虐待的恐惧及身体虐待）与成人体重及肥胖风险之间的关联。
1995 - 1997年期间进行调查的回顾性队列研究。
加利福尼亚健康维护组织中19至92岁的13177名成员。
临床检查时测量体重，随后通过邮寄调查问卷来回忆生命最初18年的经历。估计值根据成人人口统计学因素、健康行为以及儿童期家庭特征进行了调整。
约66%的参与者报告曾遭受一种或多种类型的虐待。身体虐待和言语虐待与体重及肥胖的关联最为紧密。与未遭受身体虐待者（55%）相比，“经常被打且受伤”者（2.5%）体重高出4.0千克（95%置信区间：2.4 - 5.6千克），体重指数（BMI）≥30的相对风险（RR）为1.4（1.2 - 1.6）。与未遭受言语虐待者（53%）相比，“经常遭受言语虐待”者（9.5%）BMI≥40的RR为1.9（1.3 - 2.7）。然而，这些虐待之间的关联并非相互独立，因为这些虐待类型常常同时发生。肥胖风险随着每种虐待类型的数量和严重程度增加而上升。对于BMI≥30，“任何提及”虐待（67%）的人群归因分数为8%（3.4 - 12.3%）；对于BMI≥40，该分数为17.3%（ - 1.0 - 32.4%）。
儿童期虐待与成人肥胖有关。如果存在因果关系，预防儿童虐待可能会适度降低成人肥胖率。对儿童期遭受虐待的肥胖成人进行治疗，可能会受益于对导致成人肥胖持续存在的机制的识别。
