童年期不良经历与不同类型糖尿病相关性的Meta分析  

Meta-analysis of the Correlation Between Adverse Childhood Experiences and Different Types of Diabetes Mellitus

作　　者：张译尹 ZHANG Yi-yin(School of Nursing,Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃中医药大学护理学院,甘肃兰州730000

出　　处：《医学信息》2023年第8期83-89,共7页Journal of Medical Information

摘　　要：目的系统评价童年期不良经历(ACEs)与不同类型糖尿病之间的相关性。方法计算机检索PubMed、The Cochrane Library、EMbase、CNKI、VIP、WangFang Data和CBM数据库,搜索关于ACEs与糖尿病发病风险相关性的研究,检索时限均为建库至2022年5月。由2位评价员独立筛选文献、提取资料并进行偏倚风险评价,对符合纳入标准的文献采用Stata 16.0进行Meta分析。结果最终纳入文献13篇。遭受ACEs可增加1型糖尿病和2型糖尿病的患病风险(RR=1.03,95%CI:1.00~1.06,P=0.04;RR=1.29,95%CI:1.16~1.44,P<0.05),对糖尿病前期患病风险无影响(RR=1.06,95%CI:0.94~1.21,P>0.05)。亚组分析结果显示,遭受儿童虐待和家庭功能障碍者患2型糖尿病的风险增加(RR=1.37,95%CI:1.15~1.63,P<0.05;RR=1.22,95%CI:1.08~1.38,P<0.05),多种ACEs与2型糖尿病患病风险之间存在剂量-反应效应,遭受4种及以上的ACEs者患2型糖尿病的风险更高(RR=1.89,95%CI:1.53~2.34,P<0.05)。结论遭受ACEs可增加患1型糖尿病和2型糖尿病的风险。在儿童成长中,应采取有效防范措施,减少ACEs的发生,从而降低由此造成的糖尿病患病风险。Objective To systematically evaluate the correlation between adverse childhood experiences(ACEs)and different types of diabetes mellitus.Methods PubMed,The Cochrane Library,EMbase,CNKI,VIP,WangFang Data and CBM databases were searched for studies on the correlation between ACEs and the risk of diabetes mellitus from inception to May 2022.Two reviewers independently screened literature,extracted data and assessed the risk of bias.Meta-analysis was performed on the literature that met the inclusion criteria using Stata 16.0.Results Finally,13 articles were included.Exposure to ACEs increased the risk of type 1 diabetes mellitus and type 2 diabetes mellitus(RR=1.03,95%CI:1.00-1.06,P=0.04;RR=1.29,95%CI:1.16-1.44,P<0.05),while ACEs exposure had no effect on the risk of prediabetes(RR=1.06,95%CI:0.94-1.21,P>0.05).Subgroup analysis showed that the risk of type 2 diabetes mellitus was increased in children with child abuse and family dysfunction(RR=1.37,95%CI:1.15-1.63,P<0.05;RR=1.22,95%CI:1.08-1.38,P<0.05).There was a dose-response effect between multiple ACEs and the risk of type 2 diabetes mellitus,those who suffered from four or more ACEs had a higher risk of type 2 diabetes mellitus(RR=1.89,95%CI:1.53-2.34,P<0.05).Conclusion People who suffer from ACEs increase the risk of type 1 diabetes mellitus and type 2 diabetes mellitus.Therefore,in the process of children’s growth,effective preventive measures should be taken to reduce the incidence of ACEs and thus reduce the risk of diabetes mellitus.

关 键 词：童年期不良经历 儿童虐待 家庭功能障碍 糖尿病 患病风险 

分 类 号：R179[医药卫生—妇幼卫生保健]