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被迫流离失所的影响:创伤、炎症水平升高和叙利亚难民女性糖尿病早期发病。

The impact of forced displacement: trauma, increased levels of inflammation and early presentation of diabetes in women Syrian refugees.

机构信息

College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE.

Computational Biology Center, IBM TJ Watson Research Centre, Yorktown Heights, NY, USA.

出版信息

J Public Health (Oxf). 2023 Aug 28;45(3):e437-e446. doi: 10.1093/pubmed/fdad037.

Abstract

BACKGROUND

Forced displacement and war trauma cause high rates of post-traumatic stress, anxiety disorders and depression in refugee populations. We investigated the impact of forced displacement on mental health status, gender, presentation of type 2 diabetes (T2D) and associated inflammatory markers among Syrian refugees in Lebanon.

METHODS

Mental health status was assessed using the Harvard Trauma Questionnaire (HTQ) and the Hopkins Symptom Checklist-25 (HSCL-25). Additional metabolic and inflammatory markers were analyzed.

RESULTS

Although symptomatic stress scores were observed in both men and women, women consistently displayed higher symptomatic anxiety/depression scores with the HSCL-25 (2.13 ± 0.58 versus 1.95 ± 0.63). With the HTQ, however, only women aged 35-55 years displayed symptomatic post-traumatic stress disorder (PTSD) scores (2.18 ± 0.43). Furthermore, a significantly higher prevalence of obesity, prediabetes and undiagnosed T2D were observed in women participants (23.43, 14.91 and 15.18%, respectively). Significantly high levels of the inflammatory marker serum amyloid A were observed in women (11.90 ± 11.27 versus 9.28 ± 6.93, P = 0.036).

CONCLUSIONS

Symptomatic PTSD, anxiety/depression coupled with higher levels of inflammatory marker and T2D were found in refugee women aged between 35 and 55 years favoring the strong need for psychosocial therapeutic interventions in moderating stress-related immune dysfunction and development of diabetes in this subset of female Syrian refugees.

摘要

背景

强迫流离失所和战争创伤导致难民群体中创伤后应激、焦虑症和抑郁症的发生率很高。我们研究了强迫流离失所对黎巴嫩叙利亚难民的心理健康状况、性别、2 型糖尿病(T2D)表现和相关炎症标志物的影响。

方法

使用哈佛创伤问卷(HTQ)和霍普金斯症状清单-25(HSCL-25)评估心理健康状况。分析了其他代谢和炎症标志物。

结果

尽管男性和女性都存在有症状的应激评分,但女性的 HSCL-25 表现出更高的有症状焦虑/抑郁评分(2.13±0.58 与 1.95±0.63)。然而,在用 HTQ 评估时,只有 35-55 岁的女性表现出有症状的创伤后应激障碍(PTSD)评分(2.18±0.43)。此外,女性参与者中肥胖、糖尿病前期和未确诊的 T2D 的患病率明显更高(分别为 23.43%、14.91%和 15.18%)。女性血清淀粉样蛋白 A 的炎症标志物水平显著升高(11.90±11.27 与 9.28±6.93,P=0.036)。

结论

在 35 至 55 岁的女性难民中发现了有症状的 PTSD、焦虑/抑郁,加上更高水平的炎症标志物和 T2D,这强烈需要进行心理社会治疗干预,以调节这部分女性叙利亚难民的应激相关免疫功能障碍和糖尿病的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dd2/10470347/244ef4ab49b5/fdad037f1.jpg

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