Office of Population Research, Princeton University, 261 Wallace Hall, Princeton, NJ 08544, USA.
Institute on Aging, University of Wisconsin-Madison, WI, USA.
Soc Sci Med. 2014 Mar;105:122-30. doi: 10.1016/j.socscimed.2014.01.017. Epub 2014 Jan 22.
The long-term effects of childhood trauma on health are well-documented, but few population-based studies have explored how childhood trauma affects the risk of developing metabolic syndrome (MetS) in adulthood. Using data from 1234 adults in the second wave of Midlife in the United States (MIDUS), we investigate (1) the extent to which childhood abuse affects the risk of developing MetS in adulthood; (2) how the severity of different types of abuse (emotional, physical, sexual, or cumulative abuse) affects this risk; and (3) the extent to which adult socioeconomic status (SES), maladaptive stress responses, and unhealthy behaviors mediate the association. We also test whether these associations differ significantly by sex. We find that emotional and physical abuse increase the risk of developing MetS for both sexes, whereas sexual abuse is a predictor for women only. For both sexes, individuals who experienced more cumulative abuse have a greater risk of developing MetS. Adult SES partially explains the association between childhood abuse and MetS. Maladaptive stress responses and unhealthy behaviors further explain the association. Among the potential mediators, poor sleep quality was a significant pathway for men and women, while stress-induced eating was a significant pathway for women only. Our findings suggest that the well-documented health consequences of early life trauma may vary by the nature of the trauma, the victim's sex, and the coping mechanisms that he or she employs.
儿童时期创伤对健康的长期影响已有充分记录,但很少有基于人群的研究探讨儿童创伤如何影响成年后患代谢综合征 (MetS) 的风险。我们利用来自美国中年第二期研究(MIDUS)中 1234 名成年人的数据,调查了以下问题:(1)童年期虐待在多大程度上影响成年后患代谢综合征的风险;(2)不同类型的虐待(情感、身体、性或累积虐待)的严重程度如何影响这种风险;(3)成年社会经济地位 (SES)、适应不良的应激反应和不健康行为在多大程度上调节这种关联。我们还测试了这些关联是否因性别而有显著差异。我们发现,情感和身体虐待会增加两性患代谢综合征的风险,而性虐待仅对女性是一个预测因素。对于两性来说,经历过更多累积虐待的人患代谢综合征的风险更大。成年 SES 部分解释了童年虐待与代谢综合征之间的关联。适应不良的应激反应和不健康行为进一步解释了这种关联。在潜在的中介因素中,睡眠质量差是男性和女性的一个重要途径,而应激诱导的进食是女性的一个重要途径。我们的研究结果表明,早期生活创伤的有据可查的健康后果可能因创伤的性质、受害者的性别以及他或她所采用的应对机制而有所不同。