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加利福尼亚州女性中儿童期受虐经历与成年后肥胖之间的关系。

The relationship between child abuse and adult obesity among california women.

作者信息

Alvarez Jennifer, Pavao Joanne, Baumrind Nikki, Kimerling Rachel

机构信息

Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California, USA.

出版信息

Am J Prev Med. 2007 Jul;33(1):28-33. doi: 10.1016/j.amepre.2007.02.036.

Abstract

BACKGROUND

Despite clinical studies suggesting that child abuse is associated with adult obesity, very few studies have been conducted with large community or state-based samples. This study examines the relationship between child abuse and adult obesity, relative to other risk factors such as demographics, food insecurity, inadequate fruit and vegetable consumption, and physical inactivity, in a representative sample of California women.

METHODS

Data are from the California Women's Health Survey, a state-based, random-digit-dial annual probability survey of California women. Participants included 11,115 nonpregnant women aged 18 or older, who provided complete data for all study variables. The telephone interview included assessment of child abuse (abstracted from the Traumatic Stress Schedule), food insecurity, perceived stress, physical activity, fruit and vegetable consumption, height, and weight. Data were collected in 2002, 2003, and 2004, and analyzed in 2006.

RESULTS

Obese (body mass index [BMI] of 30 or higher) women were significantly more likely to report exposure to child abuse (odds ratio [OR]=1.32, 95% confidence interval [CI]=1.23-1.42). In a multivariate model adjusted for age, race/ethnicity, education, food insecurity, inadequate fruit and vegetable consumption, physical inactivity, and perceived stress, women exposed to child abuse remained significantly more likely to be obese than unexposed women (adjusted OR=1.27, 95% CI=1.13-1.40). The population-attributable fraction of obesity associated with any type of abuse was 4.5% (95% CI=2.28-6.55).

CONCLUSIONS

Exposure to child abuse is associated with adult obesity among California women, even accounting for other relevant variables. This supports the notion that child abuse and its sequelae may be important targets for public health intervention, particularly in subpopulations where the prevalence of child abuse is known to be high.

摘要

背景

尽管临床研究表明儿童期受虐与成人肥胖有关,但针对大型社区或全州样本开展的研究却非常少。本研究在加利福尼亚州女性的代表性样本中,考察儿童期受虐与成人肥胖之间的关系,并与其他风险因素(如人口统计学特征、粮食不安全、果蔬摄入量不足及身体活动不足)进行比较。

方法

数据来自加利福尼亚州女性健康调查,这是一项基于全州、通过随机数字拨号进行的年度概率调查。参与者包括11115名18岁及以上的非孕女性,她们提供了所有研究变量的完整数据。电话访谈内容包括对儿童期受虐情况(从创伤应激量表中提取)、粮食不安全、感知压力、身体活动、果蔬摄入量、身高和体重的评估。数据于2002年、2003年和2004年收集,并于2006年进行分析。

结果

肥胖(体重指数[BMI]为30或更高)女性报告曾遭受儿童期虐待的可能性显著更高(优势比[OR]=1.32,95%置信区间[CI]=1.23 - 1.42)。在对年龄、种族/族裔、教育程度、粮食不安全、果蔬摄入量不足、身体活动不足和感知压力进行调整的多变量模型中,曾遭受儿童期虐待的女性肥胖的可能性仍显著高于未受虐女性(调整后OR=1.27,95%CI=1.13 - 1.40)。与任何类型虐待相关的肥胖人群归因分数为4.5%(95%CI=2.28 - 6.55)。

结论

在加利福尼亚州女性中,即使考虑了其他相关变量,儿童期受虐仍与成人肥胖有关。这支持了以下观点,即儿童期受虐及其后遗症可能是公共卫生干预的重要目标,尤其是在已知儿童期受虐患病率较高的亚人群中。

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