生命早期的逆境如何影响儿科发病免疫媒介炎症疾病的风险
Mikkel Malham1, Christoffer Sejling2, Megan Davies3
1Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark; Department of Pediatric- and Adolescent Medicine, Copenhagen University Hospital - Amager & Hvidovre, Kettegaard alle 36, 2650, Hvidovre, Denmark; Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents, and Adults, Copenhagen University Hospital - Hvidovre, Kettegaard alle 36, 2650, Hvidovre, Denmark; Departments of Epidemiology and Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, United States of America.
生命早期的生物逆境显著增加了儿科发病免疫媒介炎症疾病 (pIMID) 的风险. 家庭逆境显示出保护作用,需要进一步调查医疗保健差异.
科学领域:
- 儿科免疫学和流行病学
- 生命历程研究研究
- 环境对健康的影响.
背景情况:
- 儿科发病的免疫媒介性炎症性疾病 (pIMID) 的起源尚不清楚,尤其是早期生命逆境的作用.
- 这项研究调查了早期生活中相互关联的逆境对出生队列中的pIMID风险的影响.
研究的目的:
- 检查生命早期累积逆境和发展pIMID的风险之间的关联.
- 使用机器学习识别与增加的pIMID风险相关的不利状况的特定模式.
主要方法:
- 利用了1981-2015年间出生儿童的丹麦登记数据.
- 将生命早期的逆境 (前1000天) 分类为生物,物质和家庭维度.
- 采用了考克斯的比例危险模型和机器学习方法来分析pIMID发展 (年龄2-18岁).
主要成果:
- 累积的生物逆境负担与增加的pIMID风险有关 (aHR ≥4次逆境:1.8).
- 相反,多种家族逆境与降低风险相关 (aHR>2:0.66).
- 机器学习确定了一个特定的逆境模式,与一个子组的五倍高的pIMID风险相关.
结论:
- 生命早期的生物学不利因素是pIMID的重要风险因素.
- 家庭逆境的意外保护性关联可能表明弱势群体的诊断延迟.
- 潜在的医疗保健不平等需要进一步调查.
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