经历童年的逆境与炎症的显着变化有关,细胞介导的免疫能力,和皮质醇分泌。相对而言,很少有研究检查过,纵向,青春期炎症过程的改变,特别是在西方环境之外;没有人评估了有风险青年对结构化行为干预的生物标志物轨迹。我们进行了一项随机对照试验,评估了以缓解压力为目标的人道主义干预措施的有效性。与12-18岁的叙利亚难民(n=446)和约旦非难民(n=371)并排生活在约旦受战争影响的社区。我们测量了C反应蛋白(CRP),EB病毒抗体(EBV),和头发皮质醇浓度(HCC)在三个时间点(干预前/后和11个月的随访),并评估了三个主要结果(心理社会压力,心理健康,和认知功能)。使用生长混合模型,回归,和增长曲线模型,我们确定了CRP的三个不同轨迹,两个是EBV,三个是HCC,并检查了他们与年龄的关系,性别,BMI,贫穷,和创伤。我们发现CRP与BMI有关联,EBV的难民身份,BMI和性别与HCC轨迹的关系。就健康结果而言,我们发现CRP水平升高与感知压力之间存在关联(B=-2.92,p=.007),以及肝癌分泌过多和不安全之间的关系(B=7.21,p=0.017)。就干预措施的反应而言,我们观察到CRP或EBV轨迹没有不同的影响,与HCC不同。这些结果表明,常用的生物标志物与健康结果无关,并以直接的方式对有针对性的干预措施作出反应。我们的研究是第一个在受战争影响的青少年中检查多种生物标志物轨迹的研究,为了更好地评估程度,定时,以及贫困的生物特征的延展性,冲突,强迫流离失所。
Experiencing childhood adversity has been associated with significant changes in inflammation, cell-mediated immunocompetence, and cortisol secretion. Relatively few studies have examined, longitudinally, alterations to inflammatory processes during adolescence, especially outside Western contexts; none have evaluated biomarker trajectories for at-risk youth in response to a structured behavioral intervention. We conducted a randomized controlled
trial evaluating the efficacy of a humanitarian intervention targeting stress-alleviation, with 12-18 year-old Syrian refugees (n = 446) and Jordanian non-refugees (n = 371) living side-by-side in war-affected communities in Jordan. We measured C-reactive protein (CRP), Epstein-Barr virus antibodies (EBV), and hair cortisol concentration (HCC) at three timepoints (pre/post intervention and 11 month follow-up), and assessed three main outcomes (psychosocial stress, mental health, and cognitive function). Using growth mixture models, regressions, and growth curve models, we identified three distinct trajectories for CRP, two for EBV, and three for HCC, and examined their associations with age, gender, BMI, poverty, and trauma. We found associations with BMI for CRP, refugee status for EBV, and BMI and gender with HCC trajectory. In terms of health outcomes, we found associations between rising CRP levels and perceived stress (B = -2.92, p = .007), and between HCC hypersecretion and insecurity (B = 7.21, p = .017). In terms of responses to the intervention, we observed no differential impacts by CRP or EBV trajectories, unlike HCC. These results suggest that commonly-assayed biomarkers do not associate with health outcomes and respond to targeted interventions in straightforward ways. Our
study is the first to examine multiple biomarker trajectories in war-affected adolescents, in order to better evaluate the extent, timing, and malleability of the biological signatures of poverty, conflict, and forced displacement.