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儿童期虐待与成年期应激性生活事件及心血管问题之间的相互作用——一项代表性研究

The Interplay between Child Maltreatment and Stressful Life Events during Adulthood and Cardiovascular Problems-A Representative Study.

作者信息

Clemens Vera, Bürgin David, Huber-Lang Markus, Plener Paul L, Brähler Elmar, Fegert Jörg M

机构信息

Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany.

Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland.

出版信息

J Clin Med. 2021 Aug 31;10(17):3937. doi: 10.3390/jcm10173937.

Abstract

Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health.

摘要

心理压力是心血管疾病的主要危险因素。虽然早年生活压力(如儿童期受虐待所致压力)的相关性众所周知,其会长期影响个体的应激反应,但关于儿童期受虐待与成年期应激事件对心血管健康的相互作用的数据却很稀少。在此,我们旨在评估成年期应激生活事件如何与晚年的心血管健康梗死相关联,以及这种关联是否独立于儿童期受虐待情况。在一项横断面设计中,通过不同抽样步骤抽取了14岁以上德国人群的概率样本。最终样本包括2510人(53.3%为女性,平均年龄:48.4岁)。参与者被问及社会人口学因素、成年生活事件、儿童期受虐待情况以及成年期健康状况。结果表明,成年期经历的不良生活事件数量与肥胖(优势比(OR)女性 = 1.6 [1.3;2.0],OR男性 = 1.4 [1.1;1.9])、糖尿病(OR女性 = 1.5 [1.1;2.1],OR男性 = 1.5 [1.1;2.3])和心肌梗死(OR女性 = 2.1 [1.0;4.3],OR男性 = 1.8 [1.1;2.8])的显著增加的几率相关。这种关联不受儿童期受虐待经历的调节,儿童期受虐待经历独立地与心血管问题相关。综上所述,成年期应激生活事件和儿童期受虐待情况以剂量依赖的方式与德国人群中男性和女性的心血管健康显著且独立相关。全科医生、心脏病专家和卫生政策制定者应意识到儿童期和成年期心理社会应激源与心血管健康之间的这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5270/8432252/c8f63c93b076/jcm-10-03937-g001.jpg

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