Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
Department of Gastroenterology, School of Medical Sciences, Örebro University, Örebro, Sweden.
Eur J Public Health. 2018 Apr 1;28(2):364-369. doi: 10.1093/eurpub/ckx179.
Exposure to psychological stress can elicit a physiological response that may influence characteristics of the gastrointestinal mucosa, including increased intestinal permeability, in turn possibly increasing susceptibility to gastrointestinal infections. We investigated whether low stress resilience in adolescence is associated with an 'increased' risk of gastrointestinal infections in subsequent adulthood.
Data were provided by Swedish registers for a cohort of 237 577 men who underwent military conscription assessment in late adolescence (1969-76). As part of the assessment procedure, certified psychologists evaluated stress resilience through semi-structured interviews. The cohort was followed from conscription assessment until 31 December 2009 (up to age 57 years). Cox regression assessed the association of stress resilience with gastrointestinal infections (n = 5532), with adjustment for family background measures in childhood and characteristics in adolescence. Peptic ulcer disease (PUD) in adulthood was modelled as a time-dependent covariate.
Compared with high stress resilience, lower stress resilience was associated with a 'reduced' risk of gastrointestinal infections after adjustment for family background in childhood, characteristics in adolescence and PUD in adulthood, with hazard ratios (and 95% confidence intervals) of 0.88 (0.81-0.97) and 0.83 (0.77-0.88) for low and moderate stress resilience, respectively.
Lower stress resilience in adolescence is associated with reduced risk of gastrointestinal infections in adulthood, rather than the hypothesized increased risk.
暴露于心理压力下会引发生理反应，可能会影响胃肠道黏膜的特征，包括增加肠道通透性，进而可能增加胃肠道感染的易感性。我们研究了青春期低抗压能力是否与成年后胃肠道感染的“增加”风险有关。
本研究的数据来自瑞典登记处的一个队列，该队列由 237577 名男性组成，他们在青春期晚期（1969-1976 年）接受了兵役评估。作为评估程序的一部分，经过认证的心理学家通过半结构化访谈评估抗压能力。该队列从兵役评估开始跟踪随访至 2009 年 12 月 31 日（直至 57 岁）。Cox 回归评估了抗压能力与胃肠道感染（n=5532）之间的关联，调整了儿童时期的家庭背景措施和青春期的特征。成年期的消化性溃疡病（PUD）被建模为一个时变协变量。
与高抗压能力相比，低抗压能力与胃肠道感染的“降低”风险相关，调整了儿童时期的家庭背景、青春期的特征和成年期的 PUD 后，其风险比（和 95%置信区间）分别为 0.88（0.81-0.97）和 0.83（0.77-0.88）。
青春期的低抗压能力与成年期胃肠道感染的风险降低有关，而不是假设的增加风险。
