Duncan Alexis E, Auslander Wendy F, Bucholz Kathleen K, Hudson Darrell L, Stein Richard I, White Neil H
George Warren Brown School of Social Work, Washington University, One Brookings Dr, Campus Box 1196, St Louis, MO 63130. Email:
Washington University and Washington University School of Medicine, St Louis, Missouri.
Prev Chronic Dis. 2015 May 7;12:E70. doi: 10.5888/pcd12.140434.
Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults.
We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate.
Although the prevalence of diabetes was similar for men and women (7.0% vs 6.7%), men were more likely than women to have prediabetes (36.3% vs 24.6%; omnibus P < .001). Among men, recurrent sexual abuse (≥3 lifetime incidents) was significantly associated with diabetes (OR, 3.66; 95% CI, 1.31-10.24), but not with prediabetes. There was no evidence of mediation by BMI. No forms of child abuse or neglect were associated with diabetes or prediabetes among women.
Recurrent sexual abuse is robustly associated with diabetes in young adult men, independently of other forms of child abuse or neglect and BMI. Future research should explore other potential mechanisms for this association to identify avenues for prevention of diabetes among men who have experienced sexual abuse.
在全国代表性样本中,很少有研究调查虐待和忽视儿童与糖尿病之间的联系,且尚无研究探讨肥胖在这种关系中的作用。我们试图确定虐待和忽视儿童是否与糖尿病相关,如果是,肥胖是否在具有人群代表性的年轻成人样本中介导了这种关系。
我们使用了来自全国青少年健康纵向研究第四波的14493名年龄在24至34岁之间参与者的数据,以研究自我报告的儿童期虐待(性虐待、身体虐待或情感虐待)和忽视与青年期糖尿病或糖尿病前期之间的关联。我们进行了按性别分层的逻辑回归分析,以评估在加入体重指数(BMI)作为协变量前后模型中的关联。
尽管男性和女性的糖尿病患病率相似(7.0%对6.7%),但男性患糖尿病前期的可能性高于女性(36.3%对24.6%;总体P<.001)。在男性中,反复性虐待(一生中≥3次事件)与糖尿病显著相关(OR,3.66;95%CI,1.31 - 10.24),但与糖尿病前期无关。没有证据表明BMI起到中介作用。在女性中,没有任何形式的虐待或忽视儿童与糖尿病或糖尿病前期相关。
反复性虐待与年轻成年男性的糖尿病密切相关,独立于其他形式的虐待或忽视儿童以及BMI。未来的研究应探索这种关联的其他潜在机制,以确定在遭受性虐待的男性中预防糖尿病的途径。