童年期不良经历与成年人常见慢性非传染性疾病关系的研究进展

Progress in research of association of adverse childhood experiences with prevalence of common chronic diseases in adulthood

童年期不良经历(ACE)对成年后健康的影响在国际上受到越来越多的关注,但国内相关研究仍较少。本文对ACE的测量方法、其与成年人常见慢性非传染性疾病的关系和可能机制进行综述,发现国内外研究对ACE的测量范围不一,但目前的主要测量量表基本满足疾病预防的需求。绝大多数ACE类别会增加成年期常见慢性非传染性疾病的患病风险,且受到社会经济状况、年龄和性别等的影响,但有研究表明童年期经历饥荒却与高血压患病呈负相关。基于累积不平等理论,ACE的发生可导致个体生理功能损伤或采取不良的行为和生活方式,进而直接或间接增加慢性非传染性疾病患病风险,但若因该经历而早亡则可能使关联方向逆转。我国仍需更多研究证明两者的关联及相关机制,并选择合理的ACE指标,为预防措施的提出提供参考。

The effects of adverse childhood experiences on adult health has aroused increasing concern in the world in recent years,but limited studies have been conducted in China.This study synthesized the measurement of adverse childhood experiences,the association between adverse childhood experiences and the prevalence common chronic diseases in adulthood and possible mechanisms.It was found that though measurement range of adverse childhood experiences might be different among studies,current used measurement scales basically met the requirement of disease prevention.Most categories of adverse childhood experiences were positively related to risk of common chronic diseases,and the relationship was influenced by social economic status,sex and age.However,people with exposure to famine in childhood had lower prevalence of hypertension compared with those without the exposure.The possible mechanisms might be that the occurrence of adverse childhood experiences might damage physiological functions or increase the adoption of poor healthy behaviors and lifestyles,and finally increased the risk of chronic diseases directly or indirectly.While premature death due to adverse childhood experiences might reverse the association because of nonrandom selection.It is necessary for us to select appropriate indexes of adverse childhood experiences and conduct more studies to prove the association between adverse childhood experiences and prevalence of common chronic diseases in adulthood and explore the related mechanism for the better prevention of chronic diseases in China.