欧洲儿童和青少年的心理社会健康与心血管代谢标志物的横断面和纵向关联。
Cross-Sectional and Longitudinal Associations Between Psychosocial Well-Being and Cardiometabolic Markers in European Children and Adolescents.
机构信息
From the Leibniz Institute for Prevention Research and Epidemiology-BIPS (Thumann, Börnhorst, Ahrens, Rach), Bremen, Germany; Faculty of Mathematics and Computer Science (Thumann, Ahrens), University of Bremen, Bremen, Germany; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences (Thumann, De Henauw, Michels), Ghent University, Ghent, Belgium; Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy (Arvidsson), University of Gothenburg, Gothenburg, Sweden; Copenhagen Business School (Gwozdz), Frederiksberg, Denmark; Justus Liebig University Giessen (Gwozdz), Giessen, Germany; GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences (Iguacel), University of Zaragoza, Zaragoza, Spain; Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital (Mårild), The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Paediatrics, Medical School (Molnár), University of Pécs, Pécs, Hungary; Institute of Food Sciences, Consiglio Nazionale delle Ricerche (Russo), Avellino, Italy; Research and Education Institute of Child Health (Tornaritis), Strovolos, Cyprus; and Department of Chronic Diseases (Veidebaum), National Institute for Health Development, Tallinn, Estonia.
出版信息
Psychosom Med. 2020 Oct;82(8):764-773. doi: 10.1097/PSY.0000000000000845.
OBJECTIVE
Research examining aspects of positive mental health as potential predictors of cardiometabolic health in young populations is scarce. We investigated the associations between psychosocial well-being and waist circumference (WAIST), blood pressure (BP), the homeostasis model assessment for insulin resistance, triglycerides, and high-density lipoprotein cholesterol considering life-style factors as mediators.
METHODS
Data of European children and adolescents participating in the baseline (2007/2008), first follow-up (FU1; 2009/2010) and second follow-up (FU2; 2013/2014) examinations of the IDEFICS/I.Family study were used (ncross-sectional = 6519; nlongitudinal = 1393). A psychosocial well-being score was calculated from 16 items on emotional well-being, self-esteem, and social relationships (0-48 points). Cardiometabolic markers were transformed to age- and sex-specific and, in case of BP, also height-specific z scores. Life-style factors included diet, physical activity, sleep, and electronic media use. Applying path analysis, we obtained unstandardized estimates of direct and indirect effects of well-being on cardiometabolic markers.
RESULTS
Cross-sectionally, well-being score showed a negative direct and a negative indirect effect through life-style factors on WAIST z score (estimate per 4-point increase, -0.051 [p = .001] and -0.014 [p < .001], respectively). Longitudinally, positive changes in well-being score between baseline and FU1 and between FU1 and FU2, respectively, demonstrated negative indirect effects through life-style factorsFU2 on WAIST z scoreFU2. Both cross-sectionally and longitudinally, higher levels of well-being showed lowering indirect effects on homeostasis model assessment, BP, and triglyceride z scores and an increasing indirect effect on high-density lipoprotein cholesterol z score through both life-style factors and WAIST z score.
CONCLUSIONS
These results supported our hypothesis that a healthier life-style may be one mechanism through which higher well-being is linked with lower abdominal obesity and fewer other cardiometabolic disorders in young populations.
TRIAL REGISTRATION
Pan-European IDEFICS/I.Family children cohort, ISRCTN registry number: ISRCTN62310987 (http://www.isrctn.com/ISRCTN62310987).
目的
研究考察积极心理健康的各个方面作为年轻人群中心血管代谢健康的潜在预测因素，这方面的研究非常有限。我们研究了心理社会健康与腰围（WAIST）、血压（BP）、胰岛素抵抗的稳态模型评估、甘油三酯和高密度脂蛋白胆固醇之间的关联，同时考虑了生活方式因素作为中介。
方法
本研究使用了参与 IDEFICS/I.Family 研究基线（2007/2008 年）、第一次随访（FU1；2009/2010 年）和第二次随访（FU2；2013/2014 年）检查的欧洲儿童和青少年的数据（n 横断面=6519；n 纵向=1393）。从情绪健康、自尊和社会关系的 16 个项目中计算出心理社会健康评分（0-48 分）。心血管代谢标志物被转换为年龄和性别特异性，并且在血压的情况下，也被转换为身高特异性 z 分数。生活方式因素包括饮食、身体活动、睡眠和电子媒体使用。通过路径分析，我们获得了健康对心血管代谢标志物的直接和间接影响的未标准化估计值。
结果
在横断面研究中，健康评分通过生活方式因素对 WAIST z 评分表现出负向的直接和间接影响（每增加 4 分，-0.051 [p=.001]和-0.014 [p <.001]）。在纵向研究中，基线和 FU1 之间以及 FU1 和 FU2 之间的健康评分的积极变化分别通过生活方式因素对 FU2 的 WAIST z 评分表现出负向的间接影响。无论是在横断面还是纵向研究中，较高的健康水平都表现出通过生活方式因素和 WAIST z 评分对稳态模型评估、BP 和甘油三酯 z 评分的降低间接影响，以及对高密度脂蛋白胆固醇 z 评分的增加间接影响。
结论
这些结果支持了我们的假设，即更健康的生活方式可能是更高的幸福感与年轻人群中较低的腹部肥胖和其他心血管代谢疾病较少相关的一种机制。
试验注册
泛欧 IDEFICS/I.Family 儿童队列，ISRCTN 注册号：ISRCTN62310987（http://www.isrctn.com/ISRCTN62310987）。
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