Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Clinical Epidemiology Program, Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, Massachusetts; Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts.
Am J Prev Med. 2023 Jul;65(1):143-154. doi: 10.1016/j.amepre.2023.02.028. Epub 2023 Mar 5.
This meta-analysis aimed to examine the association of child abuse with adult coronary heart disease risk and separately by abuse subtypes, including emotional abuse, sexual abuse, and physical abuse.
Data were extracted from studies published up through December 2021 and on the basis of research from PubMed, Embase, CINAHL, and PsycINFO. Studies were selected if they included adults with or without any type of child abuse and measured the risk of any type of coronary heart disease. Statistical analyses were conducted in 2022. The random effects model was used to pool the effect estimates presented by RRs with 95% CIs. Heterogeneity was assessed using Q and I statistics.
The pooled estimates were synthesized using 24 effect sizes from 10 studies with a sample size of 343,371 adults. Adults with child abuse were associated with a higher risk of coronary heart disease than those without (RR=1.52; 95% CI=1.29, 1.79), and the association was similar for myocardial infarction (RR=1.50; 95 % CI=1.08, 2.10) and unspecified coronary heart disease (RR=1.58; 95% CI=1.23, 2.02). Moreover, emotional (RR=1.48; 95% CI=1.29, 1.71), sexual (RR=1.47; 95% CI=1.15, 1.88), and physical (RR=1.48; 95% CI=1.22, 1.79) abuse were associated with increased risk of coronary heart disease.
Child abuse was associated with an increased risk of adult coronary heart disease. Results were generally consistent across abuse subtypes and sex. This study advocates further research on biological mechanisms linking child abuse to coronary heart disease as well as improvement in coronary heart disease risk prediction and targeted prevention approaches.
本荟萃分析旨在研究儿童虐待与成人冠心病风险的关系，并分别按虐待亚型（包括情感虐待、性虐待和身体虐待）进行研究。
数据取自截至 2021 年 12 月发表的研究，并基于 PubMed、Embase、CINAHL 和 PsycINFO 的研究。如果研究包括有或没有任何类型儿童虐待的成年人，并测量任何类型冠心病的风险，则选择这些研究。统计分析于 2022 年进行。采用随机效应模型汇总 RR 表示的效应估计值，置信区间为 95%。采用 Q 和 I 统计量评估异质性。
使用来自 10 项研究的 24 个效应量进行汇总分析，样本量为 343371 名成年人。与没有儿童虐待的成年人相比，有儿童虐待的成年人患冠心病的风险更高（RR=1.52；95% CI=1.29，1.79），而且与心肌梗死（RR=1.50；95% CI=1.08，2.10）和未指定冠心病（RR=1.58；95% CI=1.23，2.02）的关联也相似。此外，情感虐待（RR=1.48；95% CI=1.29，1.71）、性虐待（RR=1.47；95% CI=1.15，1.88）和身体虐待（RR=1.48；95% CI=1.22，1.79）与冠心病风险增加相关。
儿童虐待与成人冠心病风险增加相关。结果在虐待亚型和性别方面基本一致。本研究倡导进一步研究将儿童虐待与冠心病联系起来的生物学机制，并改善冠心病风险预测和有针对性的预防方法。
