目的:我们调查了与威胁相关的不良儿童经历(ACE)与慢性肺部疾病(CLDs)风险之间的关系。
方法:本研究使用的数据来自中国健康与退休纵向研究(CHARLS),对来自28个省的450个村庄/城市社区的受访者进行了具有全国代表性的调查。威胁相关的ACE是使用五个不利因素构建的:家庭药物滥用,身体虐待,家庭暴力,不安全的邻居,和欺凌)。根据基线和随访时威胁相关ACE的数量,将参与者分为三组。使用逻辑回归模型计算横断面研究中威胁相关ACE与CLD患病率之间的关联。在队列研究中使用Cox比例回归模型评估威胁相关ACE与CLD发病之间的关联。在横断面研究和队列研究中都考虑了潜在的混杂因素。
结果:总人群中的CLD患病率,没有暴露组,暴露于一个威胁相关的ACE,与至少两种威胁相关的ACE的暴露率为10.07%(1320/13104),9.20%(665/7232),10.89%(421/3865),和11.66%(234/2007),分别。暴露于一种威胁相关ACE(OR:1.23,95%CI:1.07-1.41)和暴露于至少两种威胁相关ACE(OR:1.31,95%CI:1.11-1.55)与较高的CLD患病率显着相关。队列研究包括11,645名参与者。在7年的随访中,确定了738起CLD事件。同样,暴露于一种威胁相关ACE(HR:1.20,95%CI:1.01-1.43)和至少两种威胁相关ACE(HR:1.64,95%CI:1.35-2.00)与较高的CLD发生率风险显著相关.
结论:暴露于威胁相关ACE与CLD患病率和发病风险较高显著相关。识别遇到儿童威胁的个体并优先监测其肺功能至关重要。
OBJECTIVE: We investigated the association between threat-related adverse childhood experiences (ACEs) and the risk of chronic lung diseases (CLDs).
METHODS: The data used for this
study were extracted from the China Health and Retirement Longitudinal
Study (CHARLS), a nationally representative survey of respondents recruited from 450 villages/urban communities in 28 provinces. Threat-related ACEs were constructed using five adverse factors: household substance abuse, physical abuse, domestic violence, unsafe neighbourhood, and bullying). Participants were divided into three groups according to their number of threat-related ACEs at baseline and at follow-up. The association between threat-related ACEs and CLD prevalence in the cross-sectional
study was calculated using logistic regression models. The association between threat-related ACEs and CLD onset was evaluated using Cox proportional regression models in the cohort
study. Potential confounders were considered in both the cross-sectional and cohort studies.
RESULTS: The CLD prevalence in the total population, no exposure group, exposure to one threat-related ACE, and exposure to at least two threat-related ACEs were 10.07% (1320/13104), 9.20% (665/7232), 10.89% (421/3865), and 11.66% (234/2007), respectively. Exposure to one threat-related ACE (OR: 1.23, 95% CI: 1.07-1.41) and exposure to at least two threat-related ACEs (OR: 1.31, 95% CI: 1.11-1.55) were significantly associated with higher CLD prevalence rates. The cohort
study included 11,645 participants. During the 7-year follow-up, 738 CLD incidents were identified. Similarly, exposure to one threat-related ACE (HR: 1.20, 95% CI: 1.01-1.43) and at least two threat-related ACEs (HR: 1.64, 95% CI: 1.35-2.00) were significantly associated with a higher CLD incidence risk.
CONCLUSIONS: Exposure to threat-related ACEs was significantly associated with a higher CLD prevalence risk and onset. It is crucial to identify individuals who have encountered childhood threats and prioritise the monitoring of their pulmonary function.