Self‐reported child maltreatment and cardiometabolic risk in 30‐year‐old adults

Abstract

Background: Childhood maltreatment (CM) is associated with both dietary fat intake and obesity in later life. There is less information on associations with metabolic risk factors and specific types of CM such as physical, sexual and emotional abuse, as well as neglect.Aims: To assess the association between five types of self-reported CM and a range of obesity and metabolic indicators in a subsample of a birth cohort.Methods: This was a study of 1689 adults born in a major metropolitan maternity hospital in Australia and followed up 30 years later. Body mass index, bioimpedance and fasting lipid levels/insulin resistance were measured. Details on self-reported CM were collected using the Child Trauma Questionnaire. We adjusted for birth weight, parental income and relationship at participants' birth, as well as maternal age and alcohol or tobacco use. We also adjusted for participants' smoking, depression, educational level, marital and employment status at follow up.Results: One-fifth reported maltreatment (n = 362), most commonly emotional neglect (n = 175), followed by emotional abuse (n = 128), physical neglect (n = 123), sexual (n = 121) and physical abuse (n = 116). On adjusted analyses, there were significant associations for CM, particularly neglect or emotional abuse, and one or more of the following outcomes: obesity, the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and HDL levels. Results for other outcomes were more equivocal.Conclusions: Of child maltreatment types, emotional abuse and neglect show the strongest associations with obesity and several cardiometabolic risk factors, therefore highlighting the public health importance of early intervention to reduce childhood adversity.

Increased Cardiometabolic Risk in Healthy Young Adults With Early Life Stress

“…Participants with a history of ELS were also more likely to have a waist circumference and systolic blood pressure above and HDL levels below the NCEP ATP III-defined clinical cut-points for MetS. These results are consistent with prior studies that have demonstrated an association between ELS and obesity and increased adiposity, lower HDL levels, higher diastolic blood pressure, and higher hemoglobin A 1c in adolescence through mid adulthood (20,23,25,26). Measures of increased adiposity are among the most consistently reported metabolic risk factors associated with ELS, likely due to altered hypothalamic-pituitary-adrenal axis function (8,23), chronic inflammation (10), and health behaviors such as lower dietary quality (37).…”

“…This study adds to a growing body of literature that has identified ELS as a contributor to cardiometabolic risk in young adults and is among the first to examine metabolic risk in this population using a more complete risk assessment, including all the components of MetS criteria and additional other clinical risk factors such as hemoglobin A 1c and LDL cholesterol. Most prior studies in young adults have examined either individual risk factors (25,26) or the clustering of a few metabolic risk factors (10) rather than using composite metabolic risk scores. The clinical cut-point metabolic risk score was designed to include each individual component of MetS criteria, in addition to hemoglobin A 1c , all of which are individually associated with insulin resistance and elevated risk of CVD and T2DM (5).…”

“…Among adults 33 to 45 years old in the Coronary Artery Risk Development in Young Adults study, a one-unit increase in risky family score (a self-report measure assessing the family environment before age 18 years) was associated with a 1.0% higher 10-year coronary heart disease risk score (24). In a longitudinal birth cohort study of 1689 young adults, ELS (as measured by the Childhood Trauma Questionnaire [CTQ]) was significantly associated with obesity and total cholesterol/HDL-C ratio, and negatively associated with HDL levels while controlling for covariates such as age, depression, and education (25). This study did not include other important measures of metabolic risk, including hemoglobin A 1c , blood pressure measurements, or waist circumference.…”

“…This study did not include other important measures of metabolic risk, including hemoglobin A 1c , blood pressure measurements, or waist circumference. Furthermore, body mass index was the primary outcome measure of the study, which is increasingly considered problematic as it reflects muscle mass in addition to adipose tissue and does not reflect differences across individuals of different racial or ethnic backgrounds (25).…”