University of Toronto, Canada University Health Network, Canada.
Int J Psychiatry Med. 2012;43(2):165-77. doi: 10.2190/PM.43.2.e.
We sought to determine whether a reported history of childhood adversity is associated with components of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III)-defined metabolic syndrome in adults with mood disorders.
This was a cross-sectional analysis of adult outpatients (N = 373; n = 230 female, n = 143 male; mean age [SD] = 42.86 [14.43]) from the International Mood Disorders Collaborative Project (University of Toronto and Cleveland Clinic) with DSM-IV-defined major depressive disorder and bipolar I/II disorder. Childhood adversity was measured with the Klein Trauma & Abuse-Neglect self-report scale. The groups with and without childhood adversity were compared to determine possible differences in the rates of metabolic syndrome and its components. Logistic and linear regressions adjusted for age, sex, education, employment status, and smoking were used to evaluate the association between childhood adversity and components of metabolic syndrome.
For the full sample, 83 subjects (22.25%) met criteria for metabolic syndrome. Individuals reporting a history of any childhood adversity had higher systolic and diastolic blood pressure (systolic: p = 0.040; diastolic: p = 0.038). Among subjects with a history of sexual abuse, a significant proportion met criteria for obesity (45.28% vs. 32.88%; p = 0.010); a trend toward overweight was found for subjects with a history of physical abuse (76.32% vs. 63.33%; p = 0.074), although this relationship did not remain significant after adjusting for potential confounders. There was no statistically significant difference in the overall rate of dyslipidemia and/or metabolic syndrome between subjects with and without childhood adversity.
The results herein provide preliminary evidence suggesting that childhood adversity is associated with metabolic syndrome components in individuals with mood disorders.
本研究旨在探讨童年逆境经历与心境障碍患者中美国国家胆固醇教育计划成人治疗专家组第三版（NCEP-ATP-III）定义的代谢综合征各组分之间的关系。
这是一项横断面分析，研究对象为多伦多大学和克利夫兰诊所国际心境障碍合作项目中的成年门诊患者（N=373；n=230 名女性，n=143 名男性；平均年龄[标准差]为 42.86[14.43]），这些患者均符合 DSM-IV 定义的重性抑郁障碍和双相 I/II 障碍。采用 Klein 创伤与虐待自评量表来评估童年逆境经历。将有无童年逆境经历的两组进行比较，以确定代谢综合征及其各组分的发生率是否存在差异。采用调整了年龄、性别、教育程度、就业状况和吸烟状况的 logistic 和线性回归来评估童年逆境与代谢综合征各组分之间的关系。
在全样本中，83 例（22.25%）患者符合代谢综合征的诊断标准。报告有童年逆境经历的个体收缩压和舒张压更高（收缩压：p=0.040；舒张压：p=0.038）。在有性虐待史的患者中，有相当比例的患者符合肥胖标准（45.28%比 32.88%；p=0.010）；有躯体虐待史的患者超重的比例呈上升趋势（76.32%比 63.33%；p=0.074），尽管在调整了潜在混杂因素后，这种关系并不具有统计学意义。在有或无童年逆境经历的患者中，血脂异常和/或代谢综合征的总体发生率无统计学差异。
本研究结果初步表明，童年逆境经历与心境障碍患者的代谢综合征各组分有关。
