Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1505, New York, NY 10032, USA.
Nicotine Tob Res. 2012 Jan;14(1):91-7. doi: 10.1093/ntr/ntr126. Epub 2011 Oct 24.
Previous studies have found an association between child abuse and respiratory disease in some populations, but the mechanisms remain unknown, and this association has not been examined in a representative community-based sample. The goal of this study was to examine the relationship between childhood physical abuse and the odds of respiratory disease and to investigate the role of depression, anxiety, and pack-years of smoking in this association.
Data were drawn from the Midlife Development in the United States Survey (n = 3,032), a representative sample of adults aged 25-74 years. Multiple logistic regression analyses were used to determine the association between childhood abuse and current respiratory disease (past 12 months) and to examine whether pack-years of smoking, depression, and anxiety disorders mediated the relationship.
Individuals who often experienced childhood abuse had a significantly increased odds of respiratory disease (odds ratio [OR] = 1.87 [1.21, 2.90]). The association was attenuated, after adjusting for demographic characteristics and pack-years of smoking, and was no longer significant after adjusting for depression and anxiety disorders.
These results are consistent with previous data suggesting a significant association between childhood abuse and respiratory disease and extend existing knowledge by providing initial evidence that demographic differences, depression and anxiety disorders, and lifetime cigarette smoking may mediate this observed relationship. Results require replication with longitudinal data in large community-based samples. Future studies that can explore potential biological mechanisms underlying the observed associations, such as immune factors, are needed next to better understand these relationships.
先前的研究在某些人群中发现了儿童虐待与呼吸道疾病之间的关联,但机制尚不清楚,而且这种关联尚未在具有代表性的基于社区的样本中进行过检验。本研究的目的是检验儿童期身体虐待与呼吸道疾病发病几率之间的关系,并调查抑郁、焦虑和吸烟包年数在这种关联中的作用。
数据来自美国中年发展研究调查(n = 3032),这是一个年龄在 25-74 岁之间的成年人的代表性样本。采用多变量逻辑回归分析来确定儿童期虐待与当前呼吸道疾病(过去 12 个月)之间的关联,并检验吸烟包年数、抑郁和焦虑障碍是否在这种关联中起中介作用。
经常经历儿童期虐待的个体发生呼吸道疾病的几率显著增加(比值比 [OR] = 1.87 [1.21,2.90])。调整人口统计学特征和吸烟包年数后,这种关联减弱,调整抑郁和焦虑障碍后,这种关联不再显著。
这些结果与先前的数据一致,表明儿童期虐待与呼吸道疾病之间存在显著关联,并通过提供初步证据扩展了现有知识,即人口统计学差异、抑郁和焦虑障碍以及终生吸烟可能会调节这种观察到的关系。结果需要在大型基于社区的样本中使用纵向数据进行复制。接下来需要进行未来的研究来探索潜在的生物学机制,例如免疫因素,以更好地理解这些关系。