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儿童期逆境与成年早期 2 型糖尿病风险:一项涉及 120 万人的全人群队列研究结果。

Childhood adversity and risk of type 2 diabetes in early adulthood: results from a population-wide cohort study of 1.2 million individuals.

机构信息

Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Diabetologia. 2023 Jul;66(7):1218-1222. doi: 10.1007/s00125-023-05911-w. Epub 2023 Apr 20.

Abstract

AIMS/HYPOTHESIS: To examine whether childhood adversity is related to development of type 2 diabetes in early adulthood (16 to 38 years) among men and women.

METHODS

We used nationwide register data of 1,277,429 individuals born in Denmark between 1 January 1980 and 31 December 2001, who were still resident in Denmark and without diabetes at age 16 years. Individuals were divided into five childhood adversity groups based on their yearly exposure to childhood adversities (from age 0-15 years) across three dimensions: material deprivation, loss or threat of loss, and family dynamics. We estimated HR and hazard differences (HD) for type 2 diabetes according to the childhood adversity groups using Cox proportional hazards and Aalen additive hazards models.

RESULTS

During follow-up from age 16 to 31 December 2018, 4860 individuals developed type 2 diabetes. Compared with the low adversity group, the risk of type 2 diabetes was higher in all other childhood adversity groups among both men and women. For example, the risk was higher in the high adversity group characterised by high rates of adversity across all three dimensions among men (HR 2.41; 95% CI 2.04, 2.85) and women (1.58; 1.31, 1.91), translating into 36.2 (25.9, 46.5) additional cases of type 2 diabetes per 100,000 person-years among men and 18.6 (8.2, 29.0) among women.

CONCLUSIONS/INTERPRETATION: Individuals who experienced childhood adversity are at higher risk of developing type 2 diabetes in early adulthood. Intervening upon proximal determinants of adversity may help reduce the number of type 2 diabetes cases among young adults.

摘要

目的/假设:本研究旨在探讨童年逆境是否与成年早期(16 至 38 岁)男性和女性 2 型糖尿病的发生有关。

方法

我们使用了丹麦全国登记数据,其中包括 1980 年 1 月 1 日至 2001 年 12 月 31 日期间出生的 1277429 名仍居住在丹麦且在 16 岁时无糖尿病的个体。这些个体根据其在三个维度(物质匮乏、丧失或面临丧失威胁以及家庭动态)上在 0-15 岁期间每年经历的童年逆境暴露情况,被分为五个童年逆境组。我们使用 Cox 比例风险和 Aalen 加性风险模型,根据童年逆境组估计了 2 型糖尿病的 HR 和风险差异(HD)。

结果

在从 16 岁至 2018 年 12 月 31 日的随访期间,有 4860 人发生了 2 型糖尿病。与低逆境组相比,所有其他童年逆境组的男性和女性患 2 型糖尿病的风险均较高。例如,在男性中,所有三个维度的逆境发生率都很高的高逆境组中,风险更高(HR 2.41;95%CI 2.04,2.85),在女性中(1.58;1.31,1.91),这意味着男性每 10 万人年中有 36.2(25.9,46.5)例额外的 2 型糖尿病病例,女性中有 18.6(8.2,29.0)例。

结论/解释:经历过童年逆境的个体在成年早期患 2 型糖尿病的风险更高。干预童年逆境的近端决定因素可能有助于减少年轻成年人的 2 型糖尿病病例数。

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