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早期应激性生活经历如何与青少年共同的健康风险轨迹相结合,影响青年期的心血管代谢疾病风险。

How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood.

机构信息

Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1055, Miami, FL, 33136, USA.

Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA.

出版信息

J Youth Adolesc. 2021 Jun;50(6):1234-1253. doi: 10.1007/s10964-021-01440-0. Epub 2021 May 4.

Abstract

Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.

摘要

研究主要集中在早期压力生活经历(特别是社会经济逆境和虐待)与年轻人患心血管代谢疾病风险之间的附加(独特)关联,而没有考虑到乘法(协同)影响。此外,研究还没有充分考虑到健康风险轨迹(例如,物质使用、肥胖相关行为、抑郁症状)在青春期和向成年早期过渡期间的不同模式,这些模式可能将早期压力经历与后期心血管代谢疾病风险联系起来。本研究使用来自国家青少年至成人健康纵向研究(National Longitudinal Study of Adolescent to Adult Health,n=9421;女性占 55.6%)的数据,考察了从青春期到成年早期过渡期间的联合健康风险轨迹的异质性,以及它们与早期压力生活经历对年轻人患心血管代谢疾病风险的附加和乘法(协同)影响,研究时间跨度为 13 年。考虑到物质使用行为、肥胖相关行为和抑郁症状的轨迹,确定了四种不同的联合健康风险轨迹:(a)整体高风险,(b)行为风险,(c)心理肥胖风险,(d)整体低风险。社会经济逆境和虐待与年轻人患心血管代谢疾病的风险呈附加和乘法关系。当暴露于早期社会经济逆境时,具有整体高风险联合轨迹的个体在成年早期的心血管代谢疾病风险平均更高。讨论了针对经历多种健康风险的个体的个性化干预措施的意义。

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