Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Atlanta, GA, USA.
Gen Hosp Psychiatry. 2014 Mar-Apr;36(2):150-5. doi: 10.1016/j.genhosppsych.2013.10.004. Epub 2013 Oct 19.
The objective of this study is to investigate the association between childhood trauma and lipid profiles in adults from a highly traumatized population at-risk for cardiovascular disease.
We recruited 452 participants, primarily African-American and of low socioeconomic status, from general medical clinics in a large urban hospital. We performed direct comparisons, univariate analysis of variance and regression analyses together and separated by sex, examining the associations of child abuse, body mass index, lipid lowering drug use, blood pressure, age, and substance use to HDL levels and HDL/LDL ratios.
A history of moderate to severe levels of childhood trauma and abuse was associated with a significant decrease in HDL levels (P ≤ .01) and HDL/LDL ratios (P ≤ .001) relative to males with low levels of abuse. This relationship held when the status of lipid-lowering drugs was considered. When controlling for age, substance abuse, tobacco use, and adult trauma, the effects of childhood trauma remained significant. We found a significant child abuse by sex interaction on HDL/LDL ratios [F(1,369)=13.0, P ≤ .0005] consistent with a differential effect of trauma on dyslipidemia in male but not female subjects.
Our data suggest that childhood trauma exposure, obtained with self-report measures, may contribute to increased risk of cardiovascular disease by way of stress-mediated alterations of lipid concentration and composition in male, but not female, subjects.
本研究旨在探讨童年创伤与心血管疾病高危人群中成年人血脂谱之间的关系。
我们招募了 452 名参与者,主要是非洲裔美国人和社会经济地位较低的人,来自一家大型城市医院的普通医疗诊所。我们通过直接比较、单变量方差分析和回归分析,以及按性别分开,检查了儿童虐待、体重指数、降脂药物使用、血压、年龄和物质使用与高密度脂蛋白水平和高密度脂蛋白/低密度脂蛋白比值的关系。
与低水平虐待的男性相比,中重度童年创伤和虐待史与高密度脂蛋白水平(P ≤.01)和高密度脂蛋白/低密度脂蛋白比值(P ≤.001)显著降低有关。当考虑到降脂药物的状况时,这种关系仍然存在。当控制年龄、物质滥用、吸烟和成人创伤时,童年创伤的影响仍然显著。我们发现高密度脂蛋白/低密度脂蛋白比值存在显著的儿童虐待与性别交互作用[F(1,369)=13.0,P ≤.0005],这表明创伤对男性而不是女性的血脂异常有不同的影响。
我们的数据表明,通过自我报告措施获得的童年创伤暴露可能通过应激介导的男性脂质浓度和组成的改变,增加心血管疾病的风险,但对女性没有影响。