April 27, 2022
2 min read
Exposure to occasional or frequent childhood abuse was associated with risk for incident type 2 diabetes and hyperlipidemia in adulthood, according to study findings published in the Journal of the American Heart Association.
However, risk varied by race, sex and level of household organization or dysfunction during childhood, researchers reported.
“Our findings demonstrate how the negative and positive experiences we have in childhood can have long-term cardiovascular consequences in adulthood and define key heart disease risk disparities by race and sex,” Liliana Aguayo, PhD, MPH, a social epidemiologist and research assistant professor at Emory University Rollins School of Public Health, said in a press release.
Role of childhood abuse, nurturing relationships
Aguayo and colleagues analyzed data from participants in the ongoing longitudinal CARDIA study (baseline examination, 1985-1986) to examine association of exposure to abuse during childhood, measured retrospectively at the 15-year follow-up exam via the Childhood Family Environments Questionnaire, with incident obesity (n = 3,208), type 2 diabetes (n = 3,492), hypertension (n = 3,458) and hyperlipidemia (n = 2,973) assessed from baseline to year 30. Researchers also assessed whether exposure to nurturing relationships and well-organized households during childhood attenuated any associations. Analyses were stratified by race and sex.
“Nurturing relationships refer to relationships in which a parent or other adult in the household responds sensitively to meet the needs of the child by making the child feel loved, supported and cared for, and/or expressing physical affection, as opposed to feeling neglected,” the researchers wrote. “Household organization refers to a household that was regarded as organized and well managed, where family members were involved in children’s lives.”
CARDIA participants were recruited from four urban areas: Birmingham, Alabama; Chicago; Minneapolis; and Oakland, California. Most participants experienced no abuse (56%) and were exposed to high levels of nurture and household organization during childhood. The mean age of participants at baseline was 25 years, 56% of participants were women and 47% of participants were Black.
Risk differences by race, sex
Compared with no abuse exposure, researchers found that exposure to occasional or frequent abuse was associated with incident type 2 diabetes among white men (HR = 1.81; 95% CI, 1.06-3.08); there was no association between abuse exposure and type 2 diabetes for white women or Black adults. Exposure to low vs. no abuse was associated with incident hyperlipidemia among white men (HR = 1.35; 95% CI, 1.09-1.67) and white women (HR = 1.26; 95% CI, 1.01-1.56).
Risk for incident hyperlipidemia was more than tripled for white women who experienced abuse and lived in dysfunctional households (HR = 3.61; 95% CI, 1.62-8.05) and doubled for women who lived households with low levels of organization (HR = 2.05; 95% CI, 1.25-3.36) compared with white women who experienced abuse but lived in well-organized households (HR = 0.66; 95% CI, 0.41-1.06).
Researchers observed similar hyperlipidemia risk patterns for Black men who experienced occasional or frequent childhood abuse and lived in dysfunctional households (HR = 3.62; 95% CI, 1.29-10.12) or households with low organization (HR = 2.01; 95% CI, 1.08-3.72).
There were no associations between childhood abuse exposure and incident obesity or hypertension risk.
“Further research is needed to better understand the potential mechanisms linking childhood abuse and family environment to higher heart disease risk factors, as well as the impact of structural racism and social determinants of health, which likely influenced the differences we found by race and sex,” Aguayo said in the release. “This information is critical to strengthening cardiovascular disease prevention interventions and policies, particularly those that focus on people who experienced abuse or other trauma during childhood.”