Research Division, Institute of Mental Health, Singapore
Epidemiology Domain, Saw Swee Hock School of Public Health, Singapore.
BMJ Open. 2021 Mar 15;11(3):e045167. doi: 10.1136/bmjopen-2020-045167.
Several studies have linked diabetes mellitus to adverse childhood experiences (ACEs). While a number of studies have examined the association between ACEs and diabetes in Western populations, few have done it in Asian populations. The current study aimed to examine (1) the association between ACEs and diabetes, including the association after age stratification, and (2) the association of comorbid depression, resource use and health-related quality of life (HRQoL) among those with diabetes and ACEs in Singapore.
Participants were surveyed in their homes or any other preferred venue of their choice.
6126 individuals aged 18 years and above were randomly selected among Singapore residents.
Cross-sectional nationwide epidemiological study.
Exposure to any ACE was not associated with increased odds of diabetes; however, those who had experienced parental separation, death or divorce of a parent had higher odds of diabetes. In addition, we observed significant interaction between age and ACEs in relation to odds of diabetes. ACEs were significantly associated with higher odds of diabetes mainly in the younger age group. The prevalence of major depressive disorder was significantly higher among those with diabetes and ACEs than those with diabetes alone (3.7% and 0.3% respectively).
Efforts to promote regular exercise and healthy lifestyles both in the population and among those with diabetes must continue for the prevention and management of diabetes. The findings emphasise the need to create more awareness of both the prevalence and impact of ACEs among those treating chronic diseases.
多项研究表明糖尿病与不良童年经历(ACEs)有关。虽然许多研究已经在西方人群中研究了 ACEs 与糖尿病之间的关联,但在亚洲人群中研究甚少。本研究旨在检验(1)ACEs 与糖尿病之间的关联,包括按年龄分层后的关联,以及(2)在新加坡,糖尿病患者中 ACEs 与共病抑郁、资源利用和健康相关生活质量(HRQoL)之间的关联。
参与者在家中或其选择的任何其他首选场所接受调查。
在新加坡居民中随机选择了 6126 名年龄在 18 岁及以上的个体。
全国性横断面流行病学研究。
暴露于任何 ACE 与糖尿病的发病几率增加无关;然而,那些经历过父母离异、父母一方死亡或离婚的人患糖尿病的几率更高。此外,我们观察到年龄和 ACEs 与糖尿病发病几率之间存在显著的交互作用。ACEs 与糖尿病发病几率显著相关,主要发生在年龄较小的人群中。与仅患有糖尿病的患者相比,患有糖尿病和 ACEs 的患者中重度抑郁障碍的患病率明显更高(分别为 3.7%和 0.3%)。
必须继续在人群中并在患有糖尿病的人群中努力促进定期锻炼和健康的生活方式,以预防和管理糖尿病。这些发现强调了在治疗慢性病的人群中,需要提高对 ACEs 的普遍性和影响的认识。