Department of Medicine-Western Health, The University of Melbourne, Level 3, WCHRE Building, C/- Sunshine Hospital, 176 Furlong Road, St Albans, Victoria, 3021, Australia.
Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia.
Osteoporos Int. 2019 Feb;30(2):363-373. doi: 10.1007/s00198-018-4671-x. Epub 2018 Aug 21.
These data present associations between socioeconomic status (SES), different types of childhood maltreatment (CM) history and family dysfunction, and arthritis in men and women across a wide age range. Arthritis was less likely among those with higher SES, regardless of CM history.
CM has been associated with increased risk of adult-onset arthritis; however, little is known about whether socioeconomic status moderates arthritis risk in those with CM history. We investigated arthritis across education, income, and race/ethnicity and whether CM moderated associations between SES and arthritis.
Data were drawn from Wave 2 (2004-2005) of the nationally representative (USA) National Epidemiological Survey on Alcohol and Related Conditions (NESARC, n = 34,563; aged ≥ 20 years). Self-reported CM history included physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, and exposure to intimate partner violence (IPV). We used descriptive statistics and logistic regression to determine relationships between SES, CM, and arthritis. Interaction terms were used to test if CM moderated relationships between SES and arthritis.
Arthritis prevalence was 21.1% (n = 3093) among men and 30.1% (n = 6167) among women. In unadjusted analyses, women (p ≤ 0.001) and older age (both sexes, p ≤ 0.01) were associated with increased odds of arthritis. All CM types were associated with increased odds of arthritis, except exposure to IPV among women. In sex-stratified, age-adjusted analyses, lower education and income, family dysfunction, being Hispanic or Asian/Native Hawaiian/Pacific Islander, and ≥ 1 physical comorbidity were associated with increased odds of arthritis among those with and without CM: trends were similar for both sexes. In age-adjusted two-way interaction terms, CM did not moderate associations between SES and arthritis.
Although CM was associated with arthritis, associations between SES and arthritis were not amplified. Arthritis was less likely among those with higher SES, regardless of CM history.
这些数据显示了社会经济地位（SES）、不同类型的儿童期虐待（CM）史和家庭功能障碍之间的关联，以及在广泛年龄范围内男性和女性的关节炎之间的关联。无论是否有 CM 史，SES 较高的人患关节炎的可能性较小。
CM 与成人发病性关节炎的风险增加有关；然而，对于 SES 是否调节 CM 史患者的关节炎风险知之甚少。我们研究了关节炎在教育、收入和种族/族裔方面的情况，以及 CM 是否调节 SES 和关节炎之间的关联。
数据来自全国代表性（美国）国家酒精和相关条件流行病学调查（NESARC，n=34563；年龄≥20 岁）的第 2 波（2004-2005 年）。CM 史包括身体虐待、性虐待、情感虐待、情感忽视、身体忽视和亲密伴侣暴力（IPV）的暴露。我们使用描述性统计和逻辑回归来确定 SES、CM 和关节炎之间的关系。交互项用于检验 CM 是否调节 SES 和关节炎之间的关系。
男性关节炎的患病率为 21.1%（n=3093），女性为 30.1%（n=6167）。在未调整的分析中，女性（p≤0.001）和年龄较大（两性，p≤0.01）与关节炎的几率增加有关。除了女性接触 IPV 外，所有 CM 类型都与关节炎的几率增加有关。在按性别分层、年龄调整的分析中，较低的教育和收入、家庭功能障碍、西班牙裔或亚洲/原住民/太平洋岛民、≥1 种身体合并症与 CM 有和无的人患关节炎的几率增加有关：两性的趋势相似。在年龄调整的双向交互项中，CM 并没有调节 SES 和关节炎之间的关联。
尽管 CM 与关节炎有关，但 SES 与关节炎之间的关联并没有增强。SES 较高的人患关节炎的可能性较小，无论是否有 CM 史。
