PDF(Pubmed)
Abstract：
Despite Mississippi\'s high diabetes prevalence and the growing literature finding significant associations between adverse childhood experiences (ACEs) and diabetes, no research has examined the relationship between ACEs and diabetes risk in Mississippi adults. This study utilized data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) to determine if such a relationship existed. Data for Mississippi respondents were weighted to account for nonresponse bias and non-coverage errors. Each respondent\'s total ACE exposure score was calculated based on the number of ACE categories experienced. Multivariate logistic regression was utilized to model the relationship between diabetes and ACE categories and diabetes and total ACE exposure scores. Variables that were significant at p<0.05 were retained in the final (best-fitting) models. All models were adjusted for sex, age, race, level of education, income, and body mass index (BMI). After adjusting for covariates, those experiencing physical abuse (adjusted odds ratio (AOR) 1.72, 95% CI 1.69; 1.75) or sexual abuse (AOR 1.56, 95% CI 1.53; 1.58) had the highest odds of ever being diagnosed with diabetes. Experiencing one ACE (AOR 1.02, 95% CI 1.01; 1.03) was associated with slightly higher odds of having diabetes, while experiencing seven ACE categories (AOR 2.20, 95% CI 2.10; 2.31) had the highest odds. Overall, this study shows a strong association between ACEs and a diagnosis of diabetes in the state of Mississippi. This relationship represents an important focus area for prevention efforts in legislation, public health campaigns, and universal screening procedures in primary care that may decrease the prevalence and burden of diabetes in Mississippi.
摘要：
尽管密西西比州的高糖尿病患病率和越来越多的文献发现不良的童年经历（ACE）和糖尿病之间的显著关联，尚无研究在密西西比州成年人中检查ACEs与糖尿病风险之间的关系.这项研究利用了2020年行为危险因素监测系统（BRFSS）的数据来确定是否存在这种关系。密西西比州受访者的数据进行了加权，以考虑无反应偏差和非覆盖错误。每个受访者的总ACE暴露评分是根据所经历的ACE类别数量计算的。使用多变量逻辑回归模型来建立糖尿病和ACE类别以及糖尿病和总ACE暴露评分之间的关系。在p<0.05时显著的变量保留在最终(最佳拟合)模型中。所有模型都根据性别进行了调整，年龄,种族,教育水平,收入,体重指数（BMI）。在调整协变量后，那些经历身体虐待(校正比值比(AOR)1.72,95%CI1.69;1.75)或性虐待(AOR1.56,95%CI1.53;1.58)的患者被诊断为糖尿病的几率最高.经历一次ACE(AOR1.02,95%CI1.01;1.03)与糖尿病发生几率略高相关,而经历七个ACE类别(AOR2.20，95%CI2.10；2.31)的几率最高。总的来说,这项研究表明,在密西西比州,ACEs与糖尿病的诊断有很强的相关性.这种关系是立法中预防工作的重要重点领域，公共卫生运动,和初级保健中的普遍筛查程序可能降低密西西比州糖尿病的患病率和负担。
