University of Wisconsin-Madison School of Nursing, WI, United States of America.
University of Wisconsin-Madison School of Nursing, WI, United States of America.
J Pediatr Nurs. 2021 Nov-Dec;61:346-354. doi: 10.1016/j.pedn.2021.08.025. Epub 2021 Sep 21.
Sustained high stress exposure results in chronic activation of the stress response system, dysregulated stress responses, high allostatic load, and poor later-life health. Children and adolescents with chronic health conditions face stressors related to their condition in addition to those typical of childhood and adolescence, placing them at risk of high allostatic load. The purpose of this secondary analysis was to examine whether youth with chronic health conditions differ from controls on clinical measures of allostatic load.
A secondary analysis of two datasets, the electronic health record of a tertiary children's hospital and data from the Survey of the Health of Wisconsin, compared youth with chronic health conditions to controls on clinical measures of allostatic load. Additional analyses explored whether parental stress and mental health influenced these relationships.
Analyses identified differences in BMI, blood pressure, and waist circumference between youth with food allergy, anxiety, or depression, and controls. These relationships differed for males and females and for those with comorbid mental and physical conditions, and were influenced by parent stress and mental health.
Results support future studies exploring whether high stress in youth with chronic health conditions leads to increased allostatic load. Incorporating biomarkers as well as genetic and epigenetic factors will provide critical insights.
Youth with mental and physical CHCs may be at increased risk of high allostatic load, reflected in clinical measures of metabolism, and should have regular assessments of their metabolic health.
持续的高压力暴露会导致应激反应系统的慢性激活、应激反应失调、高身体负担和较差的晚年健康。患有慢性健康状况的儿童和青少年除了面临儿童和青少年时期的典型压力源外，还面临与自身状况相关的压力源，使他们面临高身体负担的风险。本二次分析的目的是检查患有慢性健康状况的年轻人与对照组在身体负担的临床测量上是否存在差异。
对两个数据集进行二次分析，一个是一家三级儿童医院的电子健康记录，另一个是威斯康星州健康调查的数据，将患有慢性健康状况的年轻人与对照组在身体负担的临床测量上进行比较。额外的分析探讨了父母的压力和心理健康是否会影响这些关系。
分析确定了食物过敏、焦虑或抑郁的年轻人与对照组之间在 BMI、血压和腰围方面存在差异。这些关系因性别和是否同时存在精神和身体疾病而有所不同，并且受到父母压力和心理健康的影响。
结果支持未来的研究，探索患有慢性健康状况的年轻人的高压力是否会导致身体负担增加。结合生物标志物以及遗传和表观遗传因素将提供关键的见解。
患有精神和身体合并性 CHC 的年轻人可能面临更高的身体负担风险，这反映在代谢的临床测量上，因此应定期评估他们的代谢健康。
