MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK.
Mol Psychiatry. 2014 May;19(5):544-54. doi: 10.1038/mp.2013.54. Epub 2013 May 21.
Obesity is a prevalent global-health problem associated with substantial morbidity, impairment and economic burden. Because most readily available forms of treatment are ineffective in the long term, it is essential to advance knowledge of obesity prevention by identifying potentially modifiable risk factors. Findings from experimental studies in non-human primates suggest that adverse childhood experiences may influence obesity risk. However, observations from human studies showed heterogeneous results. To address these inconsistencies, we performed Medline, PsycInfo and Embase searches till 1 August 2012 for articles examining the association between childhood maltreatment and obesity. We then conducted a meta-analysis of the identified studies and explored the effects of various possible sources of bias. A meta-analysis of 41 studies (190 285 participants) revealed that childhood maltreatment was associated with elevated risk of developing obesity over the life-course (odds ratio=1.36; 95% confidence interval=1.26-1.47). Results were not explained by publication bias or undue influence of individual studies. Overall, results were not significantly affected by the measures or definitions used for maltreatment or obesity, nor by confounding by childhood or adult socioeconomic status, current smoking, alcohol intake or physical activity. However, the association was not statistically significant in studies of children and adolescents, focusing on emotional neglect, or adjusting for current depression. Furthermore, the association was stronger in samples including more women and whites, but was not influenced by study quality. Child maltreatment is a potentially modifiable risk factor for obesity. Future research should clarify the mechanisms through which child maltreatment affects obesity risk and explore methods to remediate this effect.
肥胖是一个普遍存在的全球健康问题，与大量的发病率、身体损伤和经济负担有关。由于大多数现有的治疗方法在长期内都没有效果，因此通过确定潜在的可改变的风险因素来推进肥胖预防知识是至关重要的。非人类灵长类动物的实验研究结果表明，不良的童年经历可能会影响肥胖的风险。然而，来自人类研究的观察结果显示出了不一致的结果。为了解决这些不一致，我们对截至 2012 年 8 月 1 日的 Medline、PsycInfo 和 Embase 进行了检索，以寻找研究童年期虐待与肥胖之间关系的文章。然后，我们对确定的研究进行了荟萃分析，并探讨了各种可能的偏倚来源的影响。荟萃分析了 41 项研究（190285 名参与者），结果表明，童年期虐待与整个生命过程中肥胖的风险增加有关（优势比=1.36；95%置信区间=1.26-1.47）。结果不受发表偏倚或个别研究的不当影响的解释。总体而言，结果不受虐待或肥胖的衡量或定义、童年或成年社会经济地位、当前吸烟、饮酒量或身体活动的混杂因素的影响。然而，在针对儿童和青少年的研究中，关注情感忽视，或调整当前的抑郁情况，该关联没有统计学意义。此外，在包括更多女性和白人的样本中，该关联更强，但不受研究质量的影响。童年期虐待是肥胖的一个潜在可改变的风险因素。未来的研究应该阐明童年期虐待影响肥胖风险的机制，并探索纠正这种影响的方法。
