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童年期虐待与成年后患心肌梗死风险的关联:来自全国酒精相关情况的流行病学调查。

Associations between childhood maltreatment and risk of myocardial infarction in adulthood: Results from the National Epidemiologic Survey on alcohol and Related Conditions.

机构信息

Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, 40447, Taiwan; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Taichung, 40402, Taiwan.

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

出版信息

J Psychiatr Res. 2019 Sep;116:172-177. doi: 10.1016/j.jpsychires.2018.12.001. Epub 2018 Dec 4.

Abstract

OBJECTIVE

Although childhood maltreatment has been reported to be associated with the incidence of cardiovascular diseases, its association with specific major cardiovascular events remains unclear. This study aimed to examine the relationship between different types of childhood maltreatment (CM) and myocardial infarction (MI) occurrence in a nationally representative sample.

METHODS

We used data from the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative US sample of adults aged 20 years and older (N = 34, 653). Logistic regression models were constructed to investigate the associations between five types of CMs including physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse and the risk of MI adjusting for sociodemographic variables.

RESULTS

After adjusting for sociodemographic variables, childhood sexual abuse was significantly associated with increased odds of MI occurrence (adjusted odds ratio [aOR] = 1.85, 95%CI = 1.24-2.76, p = 0.003). Additionally, childhood physical abuse was significantly associated with increased odds of MI occurrence in men (aOR = 2.45, 95%CI = 1.35-4.44, p = 0.004) but this association was not observed in women (aOR = 0.72, 95%CI = 0.32-1.66, p = 0.440). Compared to those who did not experience CM, those who experienced more than three types of CMs showed increased odds of MI occurrence (adjusted OR = 2.08-3.05, all p < 0.05).

CONCLUSIONS

Using data from a nationally representative US sample of adults, we found significant positive associations between CM and odds of MI occurrence in adulthood. Future longitudinal prospective studies are needed to confirm our findings.

摘要

目的

尽管已有研究报道称儿童期虐待与心血管疾病的发生有关,但具体的主要心血管事件与儿童期虐待之间的关系尚不清楚。本研究旨在使用全国代表性样本调查不同类型的儿童期虐待(CM)与心肌梗死(MI)发生之间的关系。

方法

我们使用了来自全国酒精和相关情况流行病学调查(National Epidemiologic Survey of Alcohol and Related Conditions)的数据,该调查是一项针对年龄在 20 岁及以上的美国成年人的全国代表性样本(N=34653)。构建了逻辑回归模型,以调查包括身体虐待、身体忽视、情感虐待、情感忽视和性虐待在内的五种类型的 CM 与 MI 风险之间的关联,调整了社会人口统计学变量。

结果

调整社会人口统计学变量后,儿童期性虐待与 MI 发生的几率增加显著相关(调整后的优势比[aOR] = 1.85,95%可信区间[CI] = 1.24-2.76,p=0.003)。此外,儿童期身体虐待与男性 MI 发生的几率增加显著相关(aOR=2.45,95%CI=1.35-4.44,p=0.004),但在女性中未观察到这种关联(aOR=0.72,95%CI=0.32-1.66,p=0.440)。与未经历 CM 的人相比,经历过三种以上 CM 的人 MI 发生的几率增加(调整后的 OR=2.08-3.05,均 p<0.05)。

结论

使用来自美国成年人全国代表性样本的数据,我们发现 CM 与成年后患 MI 的几率之间存在显著的正相关。需要进行未来的纵向前瞻性研究来证实我们的发现。

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