双酚AF暴露协同增加遭受过童年期虐待的青春发育早期青少年的自杀风险：一项前瞻性队列研究

Bisphenol AF exposure synergistically increases the risk for suicidality among early adolescents with child maltreatment: A prospective cohort study

双酚AF暴露协同增加遭受过童年期虐待的青春发育早期青少年的自杀风险：一项前瞻性队列研究

Author: Yonghan Li, Mengyuan Yuan, Chao Zhang, Xueying Zhang, Jiahu Hao, Fangbiao Tao, Gengfu Wang, Puyu Su

Source: Ecotoxicology and Environmental Safety

DOI: 10.1016/j.ecoenv.2024.116511.

Abstract

Background: Child maltreatment (CM) is correlated with suicidality risk among adolescents. Additionally, exposure to bisphenol AF (BPAF) may increase this risk. However, the combined effect of CM and BPAF exposure remains unknown and should be further investigated.

Methods: In this study, 1,475 early adolescents (mean age = 12.48 years) from the Chinese Early Adolescents Cohort were enrolled. Data were collected at three time points with an interval of 12 months between 2019 and 2021. Participants’ history of CM and suicidality (including suicidal ideation and suicidal attempts) were evaluated using a self-report questionnaire. Blood samples were obtained from participants to measure serum BPAF concentrations at baseline. Group-based trajectory modeling was employed to identify different developmental trajectories of suicidality across the three waves. After adjusting for potential confounders, the association between CM and BPAF exposure on suicidal ideation and suicidal attempts was assessed using logistic regression and Poisson regression analyses.

Results: Participants with CM were associated with a risk of one- and two-year incident suicidality (all ps < 0.05), and BPAF levels were positively associated with two-year incident suicidal ideation (adjusted OR = 1.68, 95% CI: 1.13–2.50). Additionally, middle and high levels of BPAF exposure synergistically increase the risk for one- and two-year incident suicidal ideation among participants with CM (adjusted ORs = 2.00–3.83). Similarly, participants exposed to high-level BPAF as well as CM were at a greater risk of one- and two-year incident suicidal attempts than those with low-level BPAF exposure and no CM (adjusted incidence rate ratio [IRRs] = 2.82–4.34). Moreover, compared with participants with a low developmental trajectory of suicidality across the three waves, high BPAF exposure exhibited a significant synergistic effect on participants with CM in the persistently high suicidal ideation trajectory and the increasing suicidal attempts trajectory (all ps < 0.05). Sex subgroup analysis revealed that females were more susceptible to the synergistic effect of BPAF and CM exposure on suicidality than males.

Conclusions: Environmental factors and the psychological status of individuals may synergistically increase their susceptibility to suicidality. These results offer novel insights into enhancing our understanding of suicidality among adolescents.

Keywords: Child maltreatment; Bisphenol AF; Suicidal ideation; Suicidal attempts; Synergistic effect; Early adolescents

摘要

背景：童年期虐待（CM）与青少年自杀风险相关，而双酚AF（BPAF）的暴露可能会增加这一风险。然而，CM和BPAF暴露的联合效应尚不清楚，需要进一步研究。

方法：本研究纳入了来自中国青少年队列研究的1475名青春发育早期青少年（平均年龄为12.48岁）。数据收集于2019年至2021年间的三个时间点，每个时间点间隔12个月。使用自我报告问卷评估参与者的CM经历和自杀行为（包括自杀意念和自杀未遂）。参与者在基线时采集血样并测量血清BPAF浓度。采用基于群体轨迹建模来识别三个时间点上自杀行为的不同发展轨迹。在调整了潜在混杂因素后，使用逻辑回归和泊松回归分析评估CM和BPAF暴露与自杀意念和自杀未遂的关联。

结果：遭受过CM的参与者与一年和两年内自杀行为的发生风险相关（ps < 0.05），BPAF水平与两年内发生的自杀意念呈正相关（调整后OR = 1.68, 95% CI: 1.13–2.50）。此外，中高水平的BPAF暴露协同增加有CM经历参与者一年和两年内发生自杀意念的风险（调整后ORs = 2.00–3.83）。同样，暴露于高水平BPAF以及有CM经历的参与者比低水平BPAF暴露且无CM经历的参与者具有更高的一年和两年内自杀未遂发生风险（调整后发生率比[IRRs] = 2.82–4.34）。此外，与在三个时间点上低自杀行为发展轨迹组的参与者相比，高水平BPAF暴露在持续高自杀意念轨迹组和自杀未遂增加轨迹组中对有CM经历的参与者均表现出显著的协同效应（ps < 0.05）。性别亚组分析显示，女性比男性更容易受到BPAF和CM暴露对自杀行为的协同效应的影响。

结论：环境因素和个体的心理状态可能协同增加青春发育早期青少年对自杀行为的易感性。本研究为我们理解青少年自杀行为提供了新的见解。