Abstract
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].Chinese journal of Epidemiology,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
Received:December 23, 2020  
DOI:10.3760/cma.j.cn112338-20201223-01435
KeyWord: 童年期不良经历  慢性病  回顾性队列
English Key Word: Adverse childhood experience  Chronic disease  Retrospective cohort study
FundProject: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)
Author NameAffiliationE-mail
Li Jiajia Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China  
Lin Shiqi Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China  
Wu Jilei Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China  
Yu Qi Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China  
Pei Lijun Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China peilj@pku.edu.cn 
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Abstract:
      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。
English Abstract:
      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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