既往研究顯示，成年期心理問題可能導致心血管和代謝性疾病，鑒於心血管代謝性疾病起源於兒童期的新認識，美國學者們對兒童期至成年期心理問題是否影響心血管代謝風險進行了評估，結果表明，在生命的任何時間點出現心理問題均與心血管代謝風險較高有關。研究結果首次揭示了即使成年期心理問題有所緩解，其增加的心血管代謝風險仍存在;提示早期情感發育可能是終身心血管健康最初預防和改善的目標。相關論文近期在線發表於《美國心髒病學會雜誌》(J Am Coll Cardiol.)。

該研究共納入了來自英國出生隊列研究中的6714例受試者，這些受試者在45歲時重複評估了關於心理困擾和生物醫學調查。識別不同時期的心理問題(無心理問題、僅存在兒童期心理問題、僅存在成年期心理問題、持續的心理問題)。通過包括免疫、心血管和代謝係統功能的9項生物標記綜合信息評估心血管代謝風險。用協變量校正線性回歸模型評估心理問題和心血管代謝風險間的相關性。

結果顯示，與那些無心理問題的受試者相比，僅存在兒童期心理問題、僅存在成年期心理問題、持續的心理問題這三類人群的心血管代謝風險均較高，P值分別為0.0002、0.007和< 0.0001。

參考文獻：Ashley Winning, et al. J Am Coll Cardiol. 2015;66(14):1577-1586. doi:10.1016/j.jacc.2015.08.021

Psychological Distress Across the Life Course and Cardiometabolic Risk
Findings From the 1958 British Birth Cohort Study
Commentary by Dr. Valentin Fuster
Ashley Winning, ScD, MPH∗; M. Maria Glymour, ScD, MS†; Marie C. McCormick, MD, ScD∗; Paola Gilsanz, ScD, MPH∗; Laura D. Kubzansky, PhD, MPH∗
[-] Author Information
∗ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
† Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California
J Am CollCardiol. 2015;66(14):1577-1586. doi:10.1016/j.jacc.2015.08.021

Abstract
Background Research suggests cardiovascular and metabolic diseases are influenced by psychological distress in adulthood; however, this research is often limited to adult populations and/or a snapshot measure of distress. Given emerging recognition that cardiometabolic diseases have childhood origins, an important question is whether psychological distress earlier in life influences disease development.
Objectives This study sought to assess whether life course patterns of psychological distress assessed from childhood through adulthood predict biomarkers of cardiometabolic risk in adulthood and whether effects of sustained distress differ from more limited exposure.
Methods The sample (n = 6,714) consists of members of the 1958 British Birth Cohort Study who completed repeated measures of psychological distress and a biomedical survey at age 45 years. Psychological distress profiles over the life course (no distress, childhood only, adulthood only, or persistent distress) were identified from 6 assessments between ages 7 and 42 years. Cardiometabolic risk was assessed by combining information on 9 biomarkers of immune, cardiovascular, and metabolic system function. Covariate adjusted linear regression models were used to assess associations between distress profiles and cardiometabolic risk.
Results Compared with those with no distress, cardiometabolic risk was higher among people with psychological distress in childhood only (β = 0.11, SE = 0.03, p = 0.0002), in adulthood only (β = 0.09, SE = 0.03, p = 0.007), and persistent across the life course (β = 0.26, SE = 0.04, p < 0.0001).
Conclusions Psychological distress at any point in the life course is associated with higher cardiometabolic risk. This is the first study to suggest that even if distress appears to remit by adulthood, heightened risk of cardiometabolic disease remains. Findings suggest early emotional development may be a target for primordial prevention and for promoting lifelong cardiovascular health.