Rheumatology Service, Evangelic University Hospital of Curitiba, Curitiba, Brazil.
Department of Genetic, Federal University of Paraná, Curitiba, Brazil.
Clin Rheumatol. 2018 Oct;37(10):2863-2867. doi: 10.1007/s10067-018-4200-5. Epub 2018 Jul 10.
It has been suggested that the adaptive stress response may be disrupted by life adverse events such as childhood maltreatment. To investigate if the number of adverse childhood experiences (ACEs) increases susceptibility to systemic lupus erythematosus (SLE), spondyloarthritis (SpA), scleroderma (SSc), and rheumatoid arthritis (RA), we interviewed 315 patients with rheumatic disease (100 SLE; 40 SSc; 60 SpA; 115 RA) and 272 controls, using questions of the ACEs study questionnaire validated to ask about experiences of childhood abuse, negligence, domestic violence, and household dysfunctions. The questionnaire score ranges from zero (best result) to 8 (worst scenario). Patients and controls did not differ regarding the median number of ACEs (3 in both groups, patient IQR = 2.5-5 vs. control IQR = 2-5, p = 0.45). Among the patients, 63.8% (201/315) presented ACE score ≥ 3, compared with 59.9% (163/272) of the controls (p = 0.31). The proportion of patients with at least 3 ACEs did also not differ among those with different rheumatic diseases. Specifically, 64% (64/100) of those with SLE, 60% (24/40) of those with SSc, 60% (36/60) of those with SpA, and 66.9% (77/115) of those with RA reported at least 3 ACEs. There was also no difference between the distribution of ACE scores and number of individuals with ACEs ≥ 3 between patients with different rheumatic diseases and controls. Nevertheless, there was a trend for association between higher ACE score and susceptibility to RA (p = 0.06). In this setting, the occurrence of ACEs was not associated with susceptibility to rheumatic diseases in adulthood.
有人提出，适应应激反应可能会因生活中的不良事件而中断，如儿童期虐待。为了研究童年期不良经历（ACEs）的数量是否会增加系统性红斑狼疮（SLE）、脊柱关节炎（SpA）、硬皮病（SSc）和类风湿关节炎（RA）的易感性，我们对 315 名风湿性疾病患者（100 名 SLE；40 名 SSc；60 名 SpA；115 名 RA）和 272 名对照者进行了访谈，使用 ACEs 研究问卷中的问题来询问儿童期虐待、忽视、家庭暴力和家庭功能障碍的经历。问卷得分范围从 0（最佳结果）到 8（最差情况）。患者和对照组在 ACEs 的中位数数量方面没有差异（两组均为 3，患者 IQR=2.5-5 与对照组 IQR=2-5，p=0.45）。在患者中，63.8%（201/315）的 ACE 评分≥3，而对照组为 59.9%（163/272）（p=0.31）。在不同风湿性疾病的患者中，具有至少 3 个 ACEs 的患者比例也没有差异。具体而言，100 名 SLE 患者中有 64%（64/100）、40 名 SSc 患者中有 60%（24/40）、60 名 SpA 患者中有 60%（36/60）和 115 名 RA 患者中有 66.9%（77/115）报告至少有 3 个 ACEs。在不同风湿性疾病的患者和对照组之间，ACE 评分的分布和具有至少 3 个 ACEs 的个体数量之间也没有差异。然而，ACE 评分较高与 RA 易感性之间存在趋势关联（p=0.06）。在这种情况下，ACEs 的发生与成年后患风湿性疾病的易感性无关。
