From the Department of Social and Behavioral Sciences (Qureshi, Tiemeier, Kubzansky), Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Psychology, Education and Child Studies (Derks), Erasmus University Rotterdam, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology (Derks) and; The Generation R Study Group, Department of Pediatrics (Jaddoe), Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands; and Department of Epidemiology (Williams, Koenen), Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Psychosom Med. 2021 Apr 1;83(3):256-264. doi: 10.1097/PSY.0000000000000927.
Poor mental health in childhood is associated with a greater risk of cardiometabolic disease in adulthood, but less is known about when these associations begin to emerge. This study tests whether poor mental health (indexed by emotional and behavioral problems) in early childhood predicts increases in cardiometabolic dysregulation over 4 years of follow-up.
Data are from 4327 participants in the Generation R Study. Problem behaviors were reported by mothers using the Child Behavior Checklist at age 6 years. Repeated measurements of six cardiometabolic parameters were collected at ages 6 and 10 years: high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, systolic and diastolic blood pressures, C-reactive protein, and body mass index. Standardized measures were used to create continuous cardiometabolic dysregulation scores at ages 6 and 10 years. Change in dysregulation was defined as the difference in dysregulation scores over time. Cross-sectional and prospective associations were tested using linear regression, sequentially adjusting for relevant confounders. Additional analyses examined whether prospective relationships were robust to adjustment for baseline levels of dysregulation.
There was no association between child problem behaviors and cardiometabolic dysregulation at age 6 years. However, higher levels of problem behaviors predicted increases in cardiometabolic dysregulation (β = 0.12, 95% confidence interval = 0.00-0.23) from ages 6 to 10 years.
Worse child mental health may be associated with increases in cardiometabolic dysregulation by preadolescence. To our knowledge, this is the first study to demonstrate that adverse physiologic effects of psychological distress identified in adult populations may be observed as early as childhood.
儿童期心理健康状况较差与成年后患心血管代谢疾病的风险增加相关，但对于这些关联何时开始出现的了解较少。本研究旨在检验儿童早期心理健康状况较差（以情绪和行为问题为指标）是否预示着在 4 年的随访期间，心血管代谢失调会逐渐加重。
研究数据来自 Generation R 研究中的 4327 名参与者。母亲在孩子 6 岁时使用儿童行为检查表报告孩子的问题行为。在 6 岁和 10 岁时，连续测量了 6 项心血管代谢参数：高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、收缩压和舒张压、C 反应蛋白和体重指数。使用标准化测量方法在 6 岁和 10 岁时创建连续的心血管代谢失调评分。失调的变化定义为随时间失调评分的差异。使用线性回归分别对横断面和前瞻性关联进行了测试，依次调整了相关混杂因素。额外的分析检验了前瞻性关系在调整失调的基线水平后是否稳健。
儿童问题行为与 6 岁时的心血管代谢失调之间没有关联。然而，更高水平的问题行为预示着从 6 岁到 10 岁期间心血管代谢失调会逐渐加重（β=0.12，95%置信区间=0.00-0.23）。
较差的儿童心理健康状况可能与青春期前心血管代谢失调的加重有关。据我们所知，这是第一项证明在成年人群中确定的心理困扰的不良生理影响可能早在儿童期就观察到的研究。
