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Adverse childhood events and risk of diabetes onset in the 1979 National longitudinal survey of youth cohort

机译：1979年全国纵向调查青年队列的不良儿童事件和糖尿病风险

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Type 2 diabetes is a major public health problem with considerable personal and societal costs. Adverse childhood experiences (ACE) are associated with a number of serious and chronic health problems in adulthood, but these experiences have not been adequately studied in relation to diabetes in a US national sample. The association between ACE and poor health can be partially explained by greater risky health behaviors (RHB) such as smoking, heavy alcohol use, or obesity. Few studies have examined ACE in relation to adult onset Type 2 diabetes mellitus (T2DM) taking into account the role of RHB. Using longitudinal data from a representative US population sample followed over 30?years, this study examines the impact of ACE on the risk of diabetes onset. Data from the 1982 to 2012 waves of the 1979 National Longitudinal Survey of Youth were analyzed, spanning ages 14 to 56. Bivariate and discrete-time survival models were used to assess the relationships between ACE and RHB including smoking, alcohol use, and obesity, and subsequent onset of diabetes. T2DM was reported by almost 10% of participants. Over 30% of women and 21% of men reported 2+ ACE events. Women reporting 2-3 or 4+ ACE events were more likely to develop diabetes with the mean number of ACE events being greater in those with diabetes compared to without (1.28 vs.1.05, p??.0001). For men there was no significant association between ACE and diabetes onset. For women, ACE was associated with heavy drinking, current smoking, and obesity. For men, ACE was associated with being underweight and daily smoking. In multivariate discrete-time survival models, each additional ACE increased risk of T2DM onset (ORadj?=?1.14; 95% CI 1.02-1.26) for women but not for men. The relationship in women was attenuated when controlling for body mass index (BMI). ACE predicted diabetes onset among women, though this relationship was attenuated when controlling for BMI. Being overweight or obese was significantly more common among women with a history of ACE, which suggests BMI may be on the pathway from ACE to diabetes onset for women.
机译：2型糖尿病是一个主要的公共卫生问题，具有相当的个人和社会成本。不利的童年经历（ACE）与已成年期的一些严重和慢性健康问题有关，但这些经验尚未对美国国家样本的糖尿病有关。 ACE与健康状况不佳的关联可以部分地解释诸如吸烟，重饮酒或肥胖症的更大的风险健康行为（RHB）。考虑到RHB的作用，少数研究患有成年人发病2型糖尿病（T2DM）的ACE。使用来自代表性的美国人口样本的纵向数据，随之而来30多年，本研究审查了ACE对糖尿病发病风险的影响。 1982年至2012年浪潮的数据分析了对青年的国家纵向调查，跨越14至56岁。双方和离散时间生存模型用于评估ACE和RHB之间的关系，包括吸烟，酒精使用和肥胖，随后的糖尿病发作。近10％的参与者报告了T2DM。超过30％的女性和21％的男性报告了2+王牌活动。报告2-3或4岁以上事件的妇女更有可能在与没有（1.28 Vs.1.05，Pα.0001）相比，在那些糖尿病中患有糖尿病的平均数量更大的糖尿病的糖尿病。对于男性，ACE和糖尿病发病之间没有显着关联。对于女性而言，ACE与繁重的饮酒，目前的吸烟和肥胖有关。对于男性而言，ACE与体重减轻和每日吸烟有关。在多元离散时间存活模型中，每个额外的ACE增加T2DM发作的风险（Oradj？=？1.14; 95％CI 1.02-1.26），但不是男性。控制体重指数（BMI）时，妇女的关系被衰减。王牌预测糖尿病在女性中发作，尽管在控制BMI时这种关系被衰减。超重或肥胖在患有ACE历史的女性中有明显更常见，这表明BMI可能是从ACE到糖尿病发病的途径。

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