Abuse during childhood could have negative cardiometabolic outcomes later in life, according to study results published in the Journal of the American Heart Association.

Data were sourced from the Avon Longitudinal Study of Parents and Children (ALSPAC), which was a prospective, population-based cohort that recruited pregnant women in the United Kingdom between 1991 and 1992. Ongoing follow-up of children, mothers, and their partners has assessed multiple aspects of health, including exposure to physical, sexual, and psychological abuse using the Child Abuse Questionnaire and Sexual Experiences Survey. Exposure to abuse was associated with cardiometabolic health status.

The study population (N=3223) included 66.5% women, and 96.4% were White.


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Among the study participants, 5% reported physical abuse, which tended to occur at younger than 11 years. Women compared with men reported more sexual (12% vs 3%) and psychological (14% vs 10%) abuse, which most commonly occurred between 11 and 17 years of age. Physical and psychological abuse co-occurred among 64% who reported physical abuse.

At 18 years of age, adjusting for household occupational social class, parental education, ethnicity, sex, and age, higher body mass index (BMI) at 18 years associated with physical (b, 1.35 kg/m2), sexual (b, 0.57 kg/m2), and psychological (b, 0.47 kg/m2) abuse. Physical abuse associated with lower high-density lipoprotein cholesterol (b, -0.07 mmol/L) and higher C-reactive protein (b, 31%). Sexual abuse associated with increased heart rate (b, 0.57 bpm).

A significant interaction based on individuals’ sex was observed in which sexual abuse was associated with BMI (b, 2.15 kg/m2) and heart rate (b, 8.07 bpm) among men but not women.

Higher abuse scores had significant outcomes for BMI (P <.001) and heart rate (P =.041).

At 25 years of age, additional cardiometabolic patterns emerged. Individuals who experienced physical, sexual, and psychological abuse had 26%, 13%, and 9% higher insulin, respectively. Sexual abuse was associated with total cholesterol (b, -0.14 mmol/L).

There was a significant gender interaction, in which sexual abuse had a stronger effect on men (b, 6.45 bpm) than women (b, 1.48 bpm). Psychological abuse associated with triglycerides (b, 18%) and C-reactive protein (b, 31%) among men and with cholesterol (b, -0.14 mmol/L) for women.

At 25 years old, the effects on BMI (P <.001), insulin (P <.001), high-density lipoprotein cholesterol (P =.010), and cholesterol (P =.017) were related to abuse scores.

This study population was predominantly White and relatively affluent, making it unclear whether these findings may be generalizable to other populations.

“Our findings suggest downstream effects of childhood abuse on cardiometabolic risk factors in early adulthood, suggesting that young people who have experienced abuse may benefit from early screening for cardiometabolic health,” the study authors said.

Reference

Soares AG, Zimmerman A, Zammit S, Karl A, Halligan SL, Fraser A. Abuse in childhood and cardiometabolic health in early adulthood: evidence from the Avon Longitudinal Study of Parents and Children. J Am Heart Assoc. Published online December 7, 2021. doi:10.1161/JAHA.121.021701