童年不良经历与肥胖之间的关系及性别差异:系统回顾和荟萃分析。

IF 3.7 2区 医学 Q1 PSYCHIATRY
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引用次数: 0

摘要

背景:肥胖症是全球最常见的健康问题之一:肥胖症是全球最常见的健康问题之一。尽管有研究报告称童年不良经历(ACE)与肥胖之间存在关联,但具体的亚型关联和性别差异尚不清楚:系统评估 ACE 与成人肥胖风险之间的关系以及性别差异:检索了 PubMed、Web of Science、Cochrane Library、Embase 和 PsycINFO 五个数据库,检索截止日期为 2024 年 6 月 10 日。纳入的研究调查了至少一种 ACE 与肥胖之间的关系。两名研究人员使用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)及其改编版独立评估了偏倚风险,并提取了相关特征和结果。统计分析使用 STATA 17.0 进行,包括随机效应模型、异质性检验、敏感性分析、发表偏倚评估、元回归分析和亚组分析。剂量-反应分析揭示了不同滥用水平与肥胖风险之间的潜在趋势:荟萃分析包括 46 项研究,结果显示,经历过 ACE 的成年人肥胖风险明显增加(OR:1.48,95% CI:1.38-1.59)。分组分析表明,欧洲和北美的肥胖风险显著增加,发达国家和发展中国家的肥胖风险也显著增加。前瞻性研究、回顾性研究和横断面研究均显示出很强的关联性。不同类型的 ACE(身体虐待、性虐待、心理虐待以及非身体虐待、心理虐待或性虐待)与较高的肥胖风险有关。性别差异分析表明,女性在遭受身体虐待(OR:1.606)、性虐待(OR:1.581)和非身体、心理或性虐待(OR:1.319)时面临更大的风险;男性仅在遭受非身体、心理或性虐待(OR:1.240)时才表现出风险增加。剂量-反应分析表明,ACE次数越多,成人肥胖风险越高:ACE明显增加了成人肥胖的风险,不同地理区域、经济发展水平和研究设计类型的研究结果一致。性别差异分析表明,女性受影响尤为严重。未来的研究应优先纳入代表性不足的地理区域的研究,以加深了解ACE对肥胖风险的全球性影响。此外,加强儿童保护和干预工作对于减轻 ACE 对成人健康的不利影响至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between adverse childhood experiences and obesity, and sex differences: A systematic review and meta-analysis

Background

Obesity is one of the most common health problems worldwide. Although studies have reported associations between adverse childhood experiences (ACEs) and obesity, specific subtype associations and sex differences are unclear.

Objective

To systematically evaluate the association between ACEs and adult obesity risk and sex differences.

Methods

Five databases, PubMed, Web of Science, Cochrane Library, Embase, and PsycINFO, were searched with a June 10, 2024 deadline. Included studies investigated the association between at least one ACE and obesity. Two researchers independently assessed the risk of bias using the Newcastle-Ottawa Scale (NOS) and its adaptations and extracted relevant characteristics and outcomes. Statistical analyses were performed using STATA 17.0, including random effects models, heterogeneity tests, sensitivity analyses, publication bias assessments, Meta-regression analyses, and subgroup analyses. Dose-response analyses revealed potential trends between different levels of abuse and risk of obesity.

Results

The meta-analysis included 46 studies and showed a notable increased risk of obesity in adults experiencing ACEs (OR: 1.48, 95% CI: 1.38–1.59). Subgroup analyses showed significantly increased risk in Europe and North America, with significant increases observed in both developed and developing countries. Prospective, retrospective, and cross-sectional studies showed strong associations. Different types of ACEs (physical, sexual, psychological, and non-physical, psychological, or sexual abuse) were linked to a higher obesity risk. Sex difference analyses showed that females faced a greater risk when experiencing physical (OR: 1.606), sexual (OR: 1.581), and non-physical, psychological, or sexual (OR: 1.319) abuse; males exhibited increased risk only with non-physical, psychological, or sexual abuse (OR: 1.240). Dose-response analyses indicated that a higher number of ACEs was associated with an increased risk of obesity in adults.

Conclusions

ACEs significantly increase the risk of adult obesity, with consistent findings across geographic regions, levels of economic development, and types of study design. Sex difference analysis indicates that females are particularly affected. Future research should prioritize including studies from underrepresented geographic areas to enhance understanding of the global impact of ACEs on obesity risk. Additionally, strengthening child protection and intervention efforts is crucial to mitigate the adverse effects of ACEs on adult health.
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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