Sumanen Markku, Koskenvuo Markku, Sillanmäki Lauri, Mattila Kari
Kangasala Health Centre, Finland.
J Psychosom Res. 2005 Nov;59(5):331-5. doi: 10.1016/j.jpsychores.2005.04.005.
The aim of this study is to investigate associations between childhood adversities and coronary heart disease (CHD).
This was a case-control study based on a postal questionnaire addressed to randomly selected working-aged Finns, and response rate was 39% (N = 15,477). The sample comprised 319 CHD patients. Four age- and gender-matched controls were selected for every patient. The participants were asked in six questions to think about their childhood adversities.
Fear of some family member and someone in the family being seriously or chronically ill were more common during childhood among working-aged CHD patients than among controls. Likewise, among female CHD patients, serious conflicts in the family and someone in the family having had alcohol problems and, among male CHD patients, long-lasting financial problems were more common than among controls. Odds ratios (OR) varied between 1.27 and 2.66. Adjustment for education had no influence among women, but it had an influence among men. Upon adjustment for conventional risk factors (smoking, obesity, and hypertension), the association mostly disappeared. A family member having been seriously or chronically ill was statistically significant after full adjustment among both genders.
Working-aged CHD patients have experienced more dramatic events during their childhood than did the control population. This issue cannot be solved in doctors' offices. Health-promoting social policies are of vital importance.
本研究旨在调查童年逆境与冠心病(CHD)之间的关联。
这是一项病例对照研究,基于向随机抽取的工作年龄芬兰人邮寄的调查问卷展开,回复率为39%(N = 15477)。样本包括319名冠心病患者。为每位患者选取了四名年龄和性别匹配的对照。参与者被问及六个关于童年逆境的问题。
在职冠心病患者童年时期对某些家庭成员的恐惧以及家中有人患重病或慢性病的情况比对照组更为常见。同样,在女性冠心病患者中,家庭中的严重冲突以及家中有人有酗酒问题,而在男性冠心病患者中,长期的经济问题比对照组更为常见。优势比(OR)在1.27至2.66之间。教育程度调整对女性没有影响,但对男性有影响。在对传统风险因素(吸烟、肥胖和高血压)进行调整后,这种关联大多消失。在进行全面调整后,家中有人患重病或慢性病在两性中均具有统计学意义。
在职冠心病患者童年时期经历的重大事件比对照组更多。这个问题无法在医生办公室得到解决。促进健康的社会政策至关重要。