Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China.
Vanke School of Public Health, Tsinghua University, Beijing, China.
BMC Public Health. 2024 Nov 14;24(1):3163. doi: 10.1186/s12889-024-20617-3.
Adverse Childhood Experiences (ACEs) have been implicated in the development of body pain, yet research on their impact on body pain and its progression remains scarce. This study aimed to examine the associations between ACEs and the presence and areas of body pain, as well as their developmental trajectories among middle-aged and older Chinese adults.
We included participants aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. Retrospective data on ACEs and pain sites were collected with questionnaires. The presence of pain at different body sites was categorized into three areas: head & neck, trunk, and limbs. ACEs consisted of ten types of adverse experiences and were cumulatively scored. For the cross-sectional analysis (2011), logistic regressions were performed to estimate the associations between ACEs and pain presence in specific areas. In the longitudinal analysis (2011-2018), we further applied group-based trajectory modelling (GBTM) to determine the developmental trajectories of body pain. Multinomial logistic regressions were then conducted to estimate the associations between ACEs and pain trajectories.
In the cross-sectional analysis (n = 8157), ACEs were positively associated with the presence of pain in the head & neck (odds ratio [OR] = 3.55, 95% confidence intervals [CI] = 2.37-4.74), trunk (OR = 3.28, 95% CI = 2.47-4.34), and limbs areas (OR = 2.30, 95% CI = 1.77-3.00) compared to no ACEs. These associations varied by sex and residence. In the longitudinal analysis (n = 5188), GBTM identified three developmental trajectories of body pain (n = 9521): high-increasing (7.44%), low-moderate (33.67%) and maintained-low trajectories (58.89%) trajectories. Compared to participants without ACEs, individuals had three ACEs and 4 or more ACEs were consistently associated with low-moderate (three ACEs: OR = 2.26, 95% CI = 1.81-2.83, four or more ACEs: OR = 3.11, 95% CI = 2.51-3.87) and high-increasing (three ACEs: OR = 3.28, 95% CI = 2.03-5.30, four or more ACEs: OR = 6.78, 95% CI = 4.30-10.68) body pain trajectories across sexes and residence.
This study highlighted the significant association between ACEs and body pain among middle-aged and older Chinese, emphasizing the importance of preventing or mitigating ACEs as a strategy for the prevention and management of body pain.
不良的童年经历（ACEs）与身体疼痛的发展有关，但关于 ACEs 对身体疼痛及其进展的影响的研究仍然很少。本研究旨在探讨 ACEs 与中年和老年中国人身体疼痛的存在和部位之间的关系，以及它们的发展轨迹。
我们纳入了 2011 年至 2018 年期间进行的中国健康与退休纵向研究（CHARLS）中年龄在 45 岁及以上的参与者。使用问卷收集 ACEs 和疼痛部位的回顾性数据。不同身体部位的疼痛存在分为三个区域：头部和颈部、躯干和四肢。ACEs 由十种不良经历组成，并进行累积评分。对于横断面分析（2011 年），我们使用逻辑回归来估计 ACEs 与特定部位疼痛存在之间的关系。在纵向分析（2011-2018 年）中，我们进一步应用基于群组的轨迹建模（GBTM）来确定身体疼痛的发展轨迹。然后，我们使用多项逻辑回归来估计 ACEs 与疼痛轨迹之间的关系。
在横断面分析（n=8157）中，与无 ACEs 相比，ACEs 与头部和颈部（优势比[OR] = 3.55，95%置信区间[CI] = 2.37-4.74）、躯干（OR = 3.28，95%CI = 2.47-4.34）和四肢区域（OR = 2.30，95%CI = 1.77-3.00）疼痛的存在呈正相关。这些关联因性别和居住地而异。在纵向分析（n=5188）中，GBTM 确定了身体疼痛的三种发展轨迹（n=9521）：高增长（7.44%）、低中度（33.67%）和维持低轨迹（58.89%）。与无 ACEs 的参与者相比，有三个 ACEs 和 4 个或更多 ACEs 的个体与低中度（三个 ACEs：OR = 2.26，95%CI = 1.81-2.83，四个或更多 ACEs：OR = 3.11，95%CI = 2.51-3.87）和高增长（三个 ACEs：OR = 3.28，95%CI = 2.03-5.30，四个或更多 ACEs：OR = 6.78，95%CI = 4.30-10.68）身体疼痛轨迹有关，无论性别和居住地如何。
本研究强调了 ACEs 与中国中年和老年人身体疼痛之间的显著关联，强调了预防或减轻 ACEs 的重要性，作为预防和管理身体疼痛的策略。
