文章摘要
李佳佳,林是琦,武继磊,于奇,裴丽君.童年期不良经历对中老年人患慢性病影响的回顾性队列研究[J].中华流行病学杂志,2021,42(10):1804-1808
童年期不良经历对中老年人患慢性病影响的回顾性队列研究
A retrospective cohort study of the effects of the adverse childhood experience on chronic diseases of middle-aged and elderly
收稿日期:2020-12-23  出版日期:2021-10-23
DOI:10.3760/cma.j.cn112338-20201223-01435
中文关键词: 童年期不良经历;慢性病;回顾性队列
英文关键词: Adverse childhood experience;Chronic disease;Retrospective cohort study
基金项目:国家自然科学基金(41871360);国家卫生健康委员会出生缺陷预防重点实验室开放课题(ZD202002)
作者单位E-mail
李佳佳 北京大学人口研究所/北京大学中国人口健康与发展研究中心 100871  
林是琦 北京大学人口研究所/北京大学中国人口健康与发展研究中心 100871  
武继磊 北京大学人口研究所/北京大学中国人口健康与发展研究中心 100871  
于奇 北京大学人口研究所/北京大学中国人口健康与发展研究中心 100871  
裴丽君 北京大学人口研究所/北京大学中国人口健康与发展研究中心 100871 peilj@pku.edu.cn 
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中文摘要:
      目的 探讨童年期不良经历(ACE)对中老年人患慢性病的影响。方法 采用回顾性队列研究方法,以“中国健康与养老追踪调查”2014年生命历程调查为基线数据,2015年随访数据为结局构建了回顾性队列(n=12 537),采用零膨胀负二项模型分析了ACE不同暴露等级对慢性病共患数的影响。结果 与ACE暴露得分<4分的中老年人比较,ACE得分4~、6~和≥9分的中老年人共患慢性病发生率比(IRR)分别为1.10(95%CI:1.04~1.16)、1.18(95%CI:1.13~1.25)和1.34(95%CI:1.27~1.42),中老年人共患慢性病发生率比随着ACE暴露等级的增加而升高(趋势检验P<0.01),存在剂量-反应关系。结论 ACE暴露是中老年人共患慢性病的重要危险因素,开展ACE的早期筛查及干预,对降低全人群慢性病发生风险、提高中老年人生活质量和健康水平具有重要的公共卫生学意义。
英文摘要:
      Objective To investigate the adverse childhood experience (ACE) effects on the risk of chronic diseases among middle-aged and elderly. Methods A retrospective cohort study was conducted using the China Health and Retirement Longitudinal Study data. We used life history study data in 2014 as baseline data and data of chronic diseases of middle-aged and elderly in 2015 as outcomes. A zero-inflated negative-binominal model was used to estimate the incidence rate ratio (IRR) for the association between ACE and chronic diseases. Results Compared with the less than 4 points of ACE exposure in childhood, individuals with ACE exposure 4-, 6- and ≥ 9 were associated an increased risk of chronic disease, adjusted IRR (95%CI), 1.10(1.04-1.16), 1.18 (1.13-1.25), 1.34 (1.27-1.42), respectively, with a significant dose-response relationship that chronic diseases risks increase parallel with the increase of ACE exposure. Conclusions ACE might serve as one of the critical risk factors of chronic diseases in middle-aged elderly. It's of public health significance for early screening and intervention of ACE, reducing the incidence of chronic diseases, and improving middle-aged and older adults' quality of life and health.
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