Li Annie, Tu Mai Thanh, Sousa Ana Carolina, Alvarado Beatriz, Kone Georges Karna, Guralnik Jack, Zunzunegui Maria Victoria
Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.
Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
BMC Geriatr. 2015 Aug 19;15:102. doi: 10.1186/s12877-015-0104-2.
Recent studies suggest potential associations between childhood adversity and chronic inflammation at older ages. Our aim is to compare associations between childhood health, social and economic adversity and high sensitivity C-reactive protein (hsCRP) in populations of older adults living in different countries.
We used the 2012 baseline data (n = 1340) from the International Mobility in Aging Study (IMIAS) of community-dwelling people aged 65-74 years in Natal (Brazil), Manizales (Colombia) and Canada (Kingston, Ontario; Saint-Hyacinthe, Quebec). Multiple linear and Poisson regressions with robust covariance were fitted to examine the associations between early life health, social, and economic adversity and hsCRP, controlling for age, sex, financial strain, marital status, physical activity, smoking and chronic conditions both in the Canadian and in the Latin American samples.
Participants from Canadian cities have less adverse childhood conditions and better childhood self-reported health. Inflammation was lower in the Canadian cities than in Manizales and Natal. Significant associations were found between hsCRP and childhood social adversity in the Canadian but not in the Latin American samples. Among Canadian older adults, the fully-adjusted mean hsCRP was 2.2 (95% CI 1.7; 2.8) among those with none or one childhood social adversity compared with 2.8 (95% CI 2.1; 3.8) for those with two or more childhood social adversities (p = 0.053). Similarly, the prevalence of hsCRP > 3 mg/dL was 40% higher among those with higher childhood social adversity but after adjustment by health behaviors and chronic conditions the association was attenuated. No associations were observed between hsCRP and childhood poor health or childhood economic adversity.
Inflammation was higher in older participants living in the Latin American cities compared with their Canadian counterparts. Childhood social adversity, not childhood economic adversity or poor health during childhood, was an independent predictor of chronic inflammation in old age in the Canadian sample. Selective survival could possibly explain the lack of association between social adversity and hsCRP in the Latin American samples.
近期研究表明童年逆境与老年期慢性炎症之间可能存在关联。我们的目的是比较不同国家老年人群中童年健康、社会和经济逆境与高敏C反应蛋白（hsCRP）之间的关联。
我们使用了国际老年迁移研究（IMIAS）2012年的基线数据（n = 1340），该研究涉及巴西纳塔尔、哥伦比亚马尼萨莱斯以及加拿大安大略省金斯顿和魁北克省圣亚森特65 - 74岁的社区居住人群。采用稳健协方差的多元线性回归和泊松回归来检验早年生活中的健康、社会和经济逆境与hsCRP之间的关联，同时在加拿大和拉丁美洲样本中对年龄、性别、经济压力、婚姻状况、身体活动、吸烟和慢性病进行控制。
来自加拿大城市的参与者童年不良状况较少，童年自我报告的健康状况较好。加拿大城市的炎症水平低于马尼萨莱斯和纳塔尔。在加拿大样本中发现hsCRP与童年社会逆境之间存在显著关联，而在拉丁美洲样本中未发现。在加拿大老年人中，童年无社会逆境或仅有一次社会逆境的人群，经充分调整后的hsCRP均值为2.2（95%可信区间1.7；2.8），而童年有两次或更多次社会逆境的人群该均值为2.8（95%可信区间2.1；3.8）（p = 0.053）。同样，童年社会逆境程度较高者hsCRP > 3 mg/dL的患病率高出40%，但在经健康行为和慢性病调整后，这种关联减弱。未观察到hsCRP与童年健康状况差或童年经济逆境之间存在关联。
与加拿大的老年参与者相比，居住在拉丁美洲城市的老年参与者炎症水平更高。在加拿大样本中，童年社会逆境而非童年经济逆境或童年健康状况差是老年期慢性炎症的独立预测因素。选择性生存可能解释了拉丁美洲样本中社会逆境与hsCRP之间缺乏关联的原因。
