Channing Laboratory, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
J Epidemiol Community Health. 2012 Jul;66(7):629-35. doi: 10.1136/jech.2010.110932. Epub 2011 Feb 4.
This study investigated the relationship between growing up in a violent home and developmental trajectories of body mass index (BMI) in a cohort of adolescents followed longitudinally from 1996 to 2003-4.
6043 girls and 4934 boys aged 9-14 years in 1996 who reported height and weight at least two times and whose mothers completed intimate partner violence (IPV) questions at the 2001 Nurses' Health Study. Main exposure was experiencing the first family violence during early (0-5 years) or later (6-11 years) childhood, based on mother's year-specific exposure of IPV and the birth year of each participant. Mother's report of IPV was ascertained by the abuse assessment screen. Four distinct BMI trajectory groups were estimated from age-specific BMI (age 12-20 years), using general growth mixture modelling.
Four distinct BMI trajectories were identified separately for girls and boys: healthy growth; healthy to obese; steady overweight and consistently obese. Compared with boys not exposed to violence at home, boys raised in violent homes before 5 years were at increased risk of being in the consistently obese (OR =2.0; 95% CI 1.2 to 3.5) and steady overweight (OR 1.4; 95% CI 1.1 to 1.9) groups after adjusting for confounders. Girls raised in violent homes were more likely to be in the steady overweight group, but associations did not maintain statistical significance after adjusting for confounding.
These data link children's exposure to domestic violence to a risk of unhealthy weight trajectories during adolescence in boys. Detrimental effects of exposure to a domestic violence environment may take root in the first few years of development for boys.
本研究调查了在一个暴力家庭中长大与青少年从 1996 年到 2003-2004 年进行纵向随访期间身体质量指数 (BMI) 发展轨迹之间的关系。
1996 年,6043 名女孩和 4934 名 9-14 岁的男孩至少两次报告身高和体重,其母亲在 2001 年护士健康研究中完成了亲密伴侣暴力 (IPV) 问题的调查。主要暴露是在儿童早期 (0-5 岁) 或后期 (6-11 岁) 经历第一次家庭暴力,基于母亲特定年份的 IPV 暴露和每位参与者的出生年份。母亲的 IPV 报告是通过虐待评估屏幕确定的。从特定年龄的 BMI(12-20 岁)使用一般增长混合模型估计了四个不同的 BMI 轨迹组。
分别为女孩和男孩确定了四个不同的 BMI 轨迹:健康增长;健康到肥胖;稳定超重和持续肥胖。与家中未暴露于暴力的男孩相比,在 5 岁之前在暴力家庭中长大的男孩更有可能处于持续肥胖(OR=2.0;95%CI 1.2 至 3.5)和稳定超重(OR=1.4;95%CI 1.1 至 1.9)组,调整混杂因素后。在暴力家庭中长大的女孩更有可能处于稳定超重组,但在调整混杂因素后,相关性不再具有统计学意义。
这些数据将儿童暴露于家庭暴力与男孩青春期不健康体重轨迹联系起来。暴露于家庭暴力环境的有害影响可能在男孩发育的最初几年就已经扎根。