Barman Nilima, Islam Abul B M M K, Haque M Atiqul
Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh.
Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorder (BIRDEM) General Hospital, Dhaka, Bangladesh.
PLOS Glob Public Health. 2024 Jun 25;4(6):e0002715. doi: 10.1371/journal.pgph.0002715. eCollection 2024.
Adverse childhood experiences (ACEs) are potentially traumatic events that occur before 18 years of age. Studies emphasize the importance of childhood adversity as a risk factor for developing non-communicable diseases, including type-2 diabetes mellitus (T2DM) in adulthood. This case-control study involved 137 patients with T2DM and 134 non-diabetic adults of both genders (mean age 46.9 and 45.7 years, respectively). In addition to collecting socio-demographic, behavioral, and anthropological data, a 10-item ACE scale was utilized to gather information regarding childhood adversities, while perceived stress was assessed using the perceived stress scale-4. Fasting and 2-hour post glucose load blood sugar levels, HbA1c, and fasting lipid profiles were measured. Both univariable and multivariable binary logistic regression analyses were performed to investigate whether ACE is a potential risk factor for T2DM, with a significance level of 0.05. Around two-thirds of T2DM patients reported having ACE scores of 4 or higher, with the mean ACE score significantly higher in the case group than in the control group (3.96 vs. 3.34; p<0.0001). The logistic regression analysis found that T2DM was linked to female gender, hypertension, dyslipidemia, family history of DM, higher perceived stress, and a higher ACE score of 4 and above. After adjusting for confounding factors, individuals with an ACE score of 4 or higher had a significantly greater risk of developing T2DM (OR: 2.24; 95% CI 1.238-4.061). The study revealed a significant association between higher ACE scores and an increased risk of developing T2DM. As a recommendation, further investigation into the epigenetic mechanisms underlying this relationship is warranted.
童年不良经历(ACEs)是指18岁之前发生的潜在创伤性事件。研究强调童年逆境作为成年后患非传染性疾病(包括2型糖尿病(T2DM))风险因素的重要性。这项病例对照研究纳入了137例T2DM患者和134名非糖尿病成年男女(平均年龄分别为46.9岁和45.7岁)。除了收集社会人口学、行为和人类学数据外,还使用一个包含10个条目的ACE量表来收集有关童年逆境的信息,同时使用感知压力量表-4评估感知压力。测量空腹和葡萄糖负荷后2小时的血糖水平、糖化血红蛋白(HbA1c)以及空腹血脂谱。进行单变量和多变量二元逻辑回归分析,以研究ACE是否为T2DM的潜在风险因素,显著性水平为0.05。约三分之二的T2DM患者报告ACE得分在4分或更高,病例组的平均ACE得分显著高于对照组(3.96对3.34;p<0.0001)。逻辑回归分析发现,T2DM与女性性别、高血压、血脂异常、糖尿病家族史、更高的感知压力以及ACE得分4分及以上有关。在调整混杂因素后,ACE得分4分或更高的个体患T2DM的风险显著更高(比值比:2.24;95%置信区间1.238-4.061)。该研究揭示了较高的ACE得分与患T2DM风险增加之间存在显著关联。作为一项建议,有必要进一步研究这种关系背后的表观遗传机制。