Center on the Developing Child, Harvard University, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
Psychoneuroendocrinology. 2013 Dec;38(12):2854-62. doi: 10.1016/j.psyneuen.2013.07.012. Epub 2013 Aug 6.
Children with behavior problems, such as internalizing or externalizing disorders, are at increased risk for poorer physical health in adulthood. Inflammation has been posited as a potential biological mediator underlying this association. However, it is unclear how early in development associations between behavior problems and inflammation may be detected, and whether associations are present for both internalizing and externalizing behaviors in pre-pubertal children.
Using data from children in the Avon Longitudinal Study of Parents and Children, we examined associations between behavior problems at age 8 (assessed via the parent-report Strengths and Difficulties Questionnaire) and inflammatory markers assessed at age 10. Inflammatory markers included C-reactive protein (CRP; n=4069) and interleukin-6 (IL-6; n=4061). We further evaluated whether body mass index (BMI) mediated associations, and tested for potential reverse causality by considering whether age 10 inflammation was associated with changes from initial levels to age 12 behavior problems.
After adjusting for relevant covariates, age 8 externalizing behaviors were associated with elevated CRP at age 10, and age 8 internalizing and externalizing behaviors were associated with elevated IL-6 at age 10 (p's<0.05). We found no evidence that observed associations were mediated by BMI or that inflammatory markers at age 10 were associated with increased internalizing or externalizing behavior problems at age 12.
These findings document an association between behavior problems and elevated concentrations of CRP and IL-6 at 10 years. Heightened inflammation in childhood may be a pathway through which early behavior problems increase risk for adult chronic diseases.
患有行为问题的儿童，如内化或外化障碍，成年后患较差身体健康的风险增加。炎症被认为是这种关联的潜在生物学介导因素。然而，目前尚不清楚在发展过程中何时可以检测到行为问题和炎症之间的关联，以及在青春期前儿童中，这种关联是否存在于内化和外化行为。
我们使用来自雅芳纵向研究父母和儿童的数据，研究了 8 岁时（通过父母报告的《优势与困难问卷》评估）的行为问题与 10 岁时炎症标志物之间的关联。炎症标志物包括 C 反应蛋白（CRP；n=4069）和白细胞介素-6（IL-6；n=4061）。我们进一步评估了 BMI 是否介导了关联，并通过考虑 10 岁时的炎症是否与从初始水平到 12 岁时行为问题的变化相关来检验潜在的反向因果关系。
在调整了相关协变量后，8 岁时的外化行为与 10 岁时 CRP 升高有关，8 岁时的内化和外化行为与 10 岁时 IL-6 升高有关（p<0.05）。我们没有发现观察到的关联是由 BMI 介导的，或者 10 岁时的炎症标志物与 12 岁时内化或外化行为问题的增加有关。
这些发现记录了行为问题与 10 岁时 CRP 和 IL-6 浓度升高之间的关联。儿童时期炎症加剧可能是早期行为问题增加成年后慢性疾病风险的途径。
