Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.
Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China.
Soc Sci Med. 2024 Jan;341:116510. doi: 10.1016/j.socscimed.2023.116510. Epub 2023 Dec 25.
The prospective relation of childhood adversity with the risk of chronic kidney disease (CKD) remains unclear. We aimed to investigate the association of childhood adversity with new-onset CKD and examine the potential modifications by unhealthy lifestyle on this association.
A total of 115,453 adults without prior CKD at baseline were included from UK Biobank (2006-2010). Childhood adversity was retrospectively evaluated through online Childhood Trauma Screener in 2016. Six common lifestyle factors including smoking, body mass index, sleep, diet, physical activity and alcohol consumption, were combined into an unhealthy lifestyle score. New-onset CKD was the primary outcome.
The average age of participants in the study was 55.3 (SD, 7.7) years, and 39.3% of them were male. During a median follow-up duration of 14.1 years, 1905 participants developed new-onset CKD. Childhood adversity was significantly positively related with the risk of new-onset CKD in dose-response pattern. Each additional type of childhood adversity was associated with a 12% increment in the risk of developing CKD (adjusted hazard ratio (HR)1.12; 95% CI 1.08, 1.16). Among participants with high unhealthy lifestyle score, those with 4-5 types of childhood adversity increased the 1.73-fold risk of incident CKD (95% CI 1.17, 2.54) compared with those free of any childhood adversity. However, no statistically significant interaction was observed between unhealthy lifestyle and childhood adversity for new-onset CKD (P interaction = 0.734).
Childhood adversity was significantly associated with an increased risk of new-onset CKD in a dose-response pattern regardless of unhealthy lifestyle.
儿童期逆境与慢性肾脏病（CKD）风险的前瞻性关系尚不清楚。我们旨在研究儿童期逆境与新发 CKD 的关系，并探讨不健康生活方式对此关系的潜在影响。
共纳入 UK Biobank（2006-2010 年）115453 例基线时无既往 CKD 的成年人。2016 年通过在线童年创伤筛查器回顾性评估儿童期逆境。将六种常见的生活方式因素（包括吸烟、体重指数、睡眠、饮食、体力活动和饮酒）组合成一个不健康的生活方式评分。新发 CKD 是主要结局。
研究参与者的平均年龄为 55.3（SD，7.7）岁，其中 39.3%为男性。在中位随访 14.1 年期间，1905 名参与者新发 CKD。儿童期逆境与新发 CKD 的风险呈剂量反应模式的显著正相关。每增加一种儿童期逆境，发生 CKD 的风险增加 12%（调整后的危险比（HR）1.12；95%CI 1.08，1.16）。在不健康生活方式评分较高的参与者中，与无任何儿童期逆境的参与者相比，有 4-5 种儿童期逆境的参与者新发 CKD 的风险增加了 1.73 倍（95%CI 1.17，2.54）。然而，不健康生活方式和儿童期逆境与新发 CKD 之间没有观察到统计学上显著的交互作用（P 交互=0.734）。
儿童期逆境与新发 CKD 的风险呈剂量反应模式显著相关，无论不健康的生活方式如何。
