儿童虐待与中年女性的炎症有关：肥胖的作用。
Child abuse is related to inflammation in mid-life women: role of obesity.
机构信息
Department of Psychiatry, University of Pittsburgh, USA; Department of Psychology, University of Pittsburgh, USA; Department of Epidemiology, University of Pittsburgh, USA.
Department of Neurological Surgery, University of Pittsburgh, USA.
出版信息
Brain Behav Immun. 2014 Feb;36:29-34. doi: 10.1016/j.bbi.2013.09.013. Epub 2013 Sep 25.
OBJECTIVE
Elevated inflammation biomarkers are associated with incident cardiovascular disease. Several studies suggest that childhood abuse may be associated with inflammation later in life. This study examined whether childhood abuse predicted elevated levels of C-reactive protein (CRP) and whether the association was due to body size.
METHODS
Participants were 326 (104 Black, 222 White) women from the Pittsburgh site of the Study of Women's Health Across the Nation (SWAN). SWAN included a baseline assessment of pre-menopausal or early peri-menopausal women in mid-life (mean age=45.7), and CRP, depressive symptoms, body mass index (BMI), and other covariates were measured over 7 annual follow-up visits. The Childhood Trauma Questionnaire, a standardized measure that retrospectively assesses abuse and neglect in childhood and adolescence, was administered at year 8 or 9 of follow-up.
RESULTS
Approximately 37% of the participants reported a history of abuse or neglect. Generalized estimating equations showed that sexual and emotional abuse, emotional and physical neglect, and the total number of types of abuse were associated with higher CRP levels over 7 years, adjusting for race, age, education, smoking status, use of hormone therapy, depressive symptoms, occurrence of heart attack or stroke, and medications for hypertension. The coefficients for indirect effects for emotional and sexual abuse, physical neglect, and total number of types of abuse on CRP levels through BMI were significant. A history of emotional abuse and neglect was related to percent change in CRP over the 7 years but not through percent change in BMI over the 7 years.
CONCLUSION
A history of childhood abuse and neglect retrospectively reported is related to overall elevated inflammation in mid-life women, perhaps through obesity. A history of some types of abuse and neglect (emotional) may be related to change in inflammation, independent of simultaneously measured change in BMI.
目的
炎症生物标志物升高与心血管疾病的发生有关。有几项研究表明，儿童时期遭受虐待可能与以后生活中的炎症有关。本研究旨在检验儿童期虐待是否能预测 C 反应蛋白（CRP）水平升高，以及这种关联是否与体型有关。
方法
参与者为来自全国妇女健康研究匹兹堡站（SWAN）的 326 名（104 名黑人，222 名白人）女性。SWAN 在女性中年（平均年龄 45.7 岁）时进行了绝经前或早期围绝经期妇女的基线评估，并在 7 次年度随访中测量了 CRP、抑郁症状、体重指数（BMI）和其他协变量。童年创伤问卷（Childhood Trauma Questionnaire）是一种标准化的测量工具，用于回顾性评估儿童期和青春期的虐待和忽视情况，在随访的第 8 或 9 年进行。
结果
约 37%的参与者报告有虐待或忽视的经历。广义估计方程显示，性虐待和情感虐待、情感和身体忽视以及遭受虐待的类型总数与 7 年内 CRP 水平升高相关，调整了种族、年龄、教育程度、吸烟状况、激素治疗使用情况、抑郁症状、心脏病发作或中风的发生情况以及高血压药物治疗情况。情感和性虐待、身体忽视以及遭受虐待类型总数对 CRP 水平通过 BMI 的间接效应系数具有统计学意义。情感虐待和忽视的历史与 CRP 在 7 年内的变化百分比有关，但与 BMI 在 7 年内的变化百分比无关。
结论
回顾性报告的儿童期虐待和忽视史与中年女性整体炎症水平升高有关，可能是通过肥胖引起的。某些类型的虐待和忽视（情感）可能与炎症变化有关，与同时测量的 BMI 变化无关。
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