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Li L, Pinto Pereira SM, Power C. Childhood maltreatment and biomarkers for cardiometabolic disease in mid-adulthood in a prospective British birth cohort: associations and potential explanations. BMJ Open 2019; 9:e024079. [PMID: 30904846 PMCID: PMC6475361 DOI: 10.1136/bmjopen-2018-024079] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/31/2018] [Accepted: 01/28/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Research on associations between childhood maltreatment and adult cardiometabolic disease risk is sparse. We aimed to investigate associations between different forms of child maltreatment and mid-adult cardiometabolic markers and whether potential intermediaries could account for the associations observed. SETTING 1958 British birth cohort. PARTICIPANTS Approximately 9000 cohort members with data on cardiometabolic markers. OUTCOMES Adult (45y) cardiometabolic markers (blood pressure, lipids and glycated haemoglobin [HbA1c]). RESULTS Seventeen per cent of participants were identified as neglected; 6.1%, 1.6% and 10.0% were identified as experiencing physical, sexual and psychological abuse, respectively. Childhood neglect and physical abuse were associated with high body mass index (BMI) and large waist circumference when adjusting for early-life covariates. For neglect, the adjusted odds ratio (AOR) was 1.16 (95% CI: 1.02 to 1.32) and 1.15 (1.02 to 1.30) for general and central obesity, respectively, and for physical abuse, the respective AOR was 1.36 (1.13 to 1.64) and 1.38 (1.16 to 1.65). Neglect was also associated with raised triglycerides by 3.9 (0.3 to 7.5)% and HbA1c by 1.2 (0.4 to 2.0)%, and among females, lower high-density lipoprotein cholesterol (HDL-c) by 0.05 (0.01 to 0.08)mmol/L after adjustment. For physical abuse, the AOR was 1.25 (1.00 to 1.56) for high low-density lipoprotein cholesterol, HbA1c was raised by 2.5 (0.7 to 4.3)% (in males) and HDL-c was lower by 0.06 (0.01 to 0.12)mmol/L (in females). Associations for sexual abuse were similar to those for physical abuse but 95% CIs were wide. For psychological abuse, the AOR for elevated triglycerides was 1.21 (1.02 to 1.44) and HDL-c was lower by 0.04 (0.01 to 0.07)mmol/L. Maltreatments were not associated with raised blood pressure. In analyses of potential intermediary factors, several associations attenuated after adjustment for adult lifestyles (mainly smoking and alcohol consumption rather than physical activity) and child-to-adult BMI. CONCLUSIONS Childhood maltreatments, particularly neglect and physical abuse, were associated with greater adiposity and poorer lipid and HbA1c profiles decades later in adulthood. Associations were modest but independent of early-life factors linked to these outcomes. Findings implicate adult lifestyles as an important intermediary between child maltreatment and outcomes.
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Affiliation(s)
- Leah Li
- Population, Policy and Practice Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Snehal M Pinto Pereira
- Population, Policy and Practice Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Christine Power
- Population, Policy and Practice Programme, University College London Great Ormond Street Institute of Child Health, London, UK
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102
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Zarse EM, Neff MR, Yoder R, Hulvershorn L, Chambers JE, Chambers RA. The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1581447] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Emily M. Zarse
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Midtown Mental Health Center/Eskenazi Hospital, Indianapolis, IN, USA
| | - Mallory R. Neff
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Child Psychiatry, Riley Hospital, IU School of Medicine, Indianapolis, IN, USA
| | - Rachel Yoder
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Child Psychiatry, Riley Hospital, IU School of Medicine, Indianapolis, IN, USA
| | - Leslie Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Child Psychiatry, Riley Hospital, IU School of Medicine, Indianapolis, IN, USA
| | - Joanna E. Chambers
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Midtown Mental Health Center/Eskenazi Hospital, Indianapolis, IN, USA
| | - R. Andrew Chambers
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Midtown Mental Health Center/Eskenazi Hospital, Indianapolis, IN, USA
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103
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Oh JH, Hong YM. Blood Pressure Trajectories from Childhood to Adolescence in Pediatric Hypertension. Korean Circ J 2019; 49:223-237. [PMID: 30808073 PMCID: PMC6393321 DOI: 10.4070/kcj.2018.0448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/24/2018] [Indexed: 11/29/2022] Open
Abstract
It has been known for a long time that elevated blood pressure (BP) in the young may persist and progress into adult hypertension (HTN). Multiple studies have revealed the predicted BP trajectory lines starting from childhood and related them to later cardiovascular (CV) risks in adulthood. As a small baby grows into a tall adult, BP will also naturally increase. Among early-life predictors of adult HTN, birth history, such as prematurity, and low birth weight have been popular subjects in research on pediatric HTN, because body size at birth has been reported to be inversely related to the risk of adulthood HTN. The hypothesis of HTN in prematurely born adolescents has been postulated as a physiological predisposition to postnatal excessive weight gain. Current body weight is a well-known independent predictor of HTN in children, and some studies showed that children demonstrating upward crossing of their weight percentiles while growing into adolescents have significantly increased risk for elevated BP later in life. Recently, reports focused on the adverse effect of excessive catch-up growth in this population are gradually drawing attention. Accordingly, children born prematurely or with intrauterine growth restriction who show rapid changes in their weight percentile should be under surveillance with BP monitoring. Prevention of childhood obesity, along with special care for premature infants or infants small for their gestational age, by providing healthy nutritional guidelines should be cardinal strategies for the prevention of adult HTN and CV risks later in life.
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Affiliation(s)
- Jin Hee Oh
- Department of Pediatrics, St.Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Young Mi Hong
- Department of Pediatrics, Ewha Womans University Hospital College of Medicine, Seoul, Korea.
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104
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Rentas KG, Buckley L, Wiest D, Bruno CA. Characteristics and behavioral health needs of patients with patterns of high hospital use: implications for primary care providers. BMC Health Serv Res 2019; 19:81. [PMID: 30732608 PMCID: PMC6367800 DOI: 10.1186/s12913-019-3894-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 01/10/2019] [Indexed: 11/12/2022] Open
Abstract
Background A small percentage of patients relies extensively on hospital-based care and account for a disproportionately high share of health care spending in the United States. Evidence shows that behavioral health conditions are common among these individuals, but understanding of their behavioral health needs is limited. This study aimed to understand the behavioral health characteristics and needs of patients with high hospital utilization patterns in Camden, New Jersey. Methods The sample consisted of patients in a care management intervention for individuals with patterns of high hospital utilization who were referred for behavioral health assessments (N = 195). A clinical psychologist conducted the assessments, which informed a multiaxial evaluation with diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders and a Mental Status Examination, to facilitate accurate diagnosis. Demographic characteristics, housing instability, exposure to trauma, and health care service utilization data were also collected through self-report and chart reviews. Results Ninety percent of patients were diagnosed with a psychiatric and/or active substance use disorder. Depression was the most common psychiatric disorder and alcohol use was the most common substance use disorder. However, only 10% of patients with an active substance use disorder were in treatment, and only 17% of patients with a mental health diagnosis were receiving mental health treatment. Nearly all (91%) patients reported having a primary care provider at the time of assessment and most had seen their primary care provider within three months of their last hospital discharge. Non-medical barriers to health and wellness, specifically housing instability and exposure to trauma, were also common (35 and 61% of patients, respectively) among patients. Conclusion Findings highlight the importance of identifying and treating patients with behavioral health needs in the primary care setting. Developing connections with community agencies who provide behavioral health and substance use treatment can enhance primary care providers’ efforts to address their patients’ non-medical barriers to treatment, as can embedding behavioral health providers within primary care offices. The study also underscores the need for trauma-informed care in primary care settings.
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Affiliation(s)
- Karen G Rentas
- Providence Health & Services, 11333 Sepulveda Blvd, Mission Hills, CA, 91345, USA
| | - Laura Buckley
- Camden Coalition of Healthcare Providers, 800 Cooper Street, 7th Floor, Camden, NJ, 08102, USA
| | - Dawn Wiest
- Camden Coalition of Healthcare Providers, 800 Cooper Street, 7th Floor, Camden, NJ, 08102, USA.
| | - Cortney A Bruno
- Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19146, USA
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105
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Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
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Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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106
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Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, Lv Y, Xu X, Wang K, Wang Y, Deng Y, Yan B, Yang R, Yang J, Ren Y, Yuan Z. Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age. J Am Soc Nephrol 2018; 29:2835-2846. [PMID: 30420422 DOI: 10.1681/asn.2018030263] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/10/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Although high BP is one of the most important factors affecting renal function, whether longitudinal BP trajectories in early life course are associated with renal function damage in later life is unclear. METHODS To investigate the correlation between BP trajectories from childhood to adulthood and renal function in middle age, we used group-based trajectory models to identify BP trajectories in 2430 individuals (aged 6-15 years old at baseline) participating in the ongoing Hanzhong Adolescent Hypertension Cohort. We tested the association between these trajectories and subclinical renal damage in middle age, adjusting for several covariates. RESULTS We identified four distinct systolic BP trajectories among 2430 subjects: low stable, moderate stable, high stable, and moderate increasing on the basis of systolic BP levels at baseline and during the 30-year follow-up period. The urinary albumin-to-creatinine ratio (uACR) was higher in moderate stable, high stable, and moderate increasing groups compared with the low stable group. A total of 228 individuals had subclinical renal disease by 2017. Compared with the low stable trajectory group, the other groups had increasingly greater odds of experiencing subclinical renal disease in middle age. These associations were not altered after adjustment for other covariates, except for in the moderate stable group. Analyzed results were similar for the mean arterial pressure and diastolic BP trajectory groups. CONCLUSIONS Higher BP trajectories were correlated with higher of uACR levels and risk of subclinical renal disease in middle age. Identifying long-term BP trajectories from early age may assist in predicting individuals' renal function in later life.
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Affiliation(s)
- Wenling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Jianjun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China;
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Jiawen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yongbo Lv
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xianjing Xu
- Department of Cardiovascular Medicine, Henan Province People's Hospital, Zhengzhou, People's Republic of China
| | - Keke Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Ying Deng
- Department of Cardiovascular Medicine, Hanzhong No. 405 Hospital, Hanzhong, People's Republic of China
| | - Bo Yan
- Department of Cardiovascular Medicine, Hanzhong Central Hospital, Hanzhong, People's Republic of China; and
| | - Ruihai Yang
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Jun Yang
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Yong Ren
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
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107
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Deighton S, Neville A, Pusch D, Dobson K. Biomarkers of adverse childhood experiences: A scoping review. Psychiatry Res 2018; 269:719-732. [PMID: 30273897 DOI: 10.1016/j.psychres.2018.08.097] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences that occur during childhood. Research has demonstrated a link between ACEs and risk of physical and mental health disorders, where early life adversity may become "biologically embedded" and have wide-ranging effects on various physiological systems. The aim of this study was to identify the extent and breadth of recent research activity relating to biological measures of ACEs in adulthood. We undertook a scoping review including published research articles. Medline and PsycINFO were searched for articles from 2007 to July 2017. Articles were eligible if they included adult participants, were written in English, and reported on a biomarker of childhood adversity in adulthood. Forty articles met our inclusion criteria. Studies investigated a range of ACEs that were often measured retrospectively. The studies identified biomarkers related to inflammation (e.g., CRP), cardio/metabolic systems (e.g., BMI), genetics (e.g., telomere length), and endocrine systems (e.g., cortisol), as well as composites of multiple physiological systems. However, not every study identified found significant associations. Health behaviours, emotional distress, social relationships, and socioeconomic factors may help explain some of these associations. Further research is needed to better understand biomarkers of ACEs in adulthood and their relationship to health conditions.
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Affiliation(s)
| | | | - Dennis Pusch
- Southport Psychological Services, Alberta, Calgary, Canada
| | - Keith Dobson
- University of Calgary, Department of Psychology, Alberta, Canada
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108
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Dietz LJ, Pham SV, Melhem N, Porta G, Brent DA. Blood pressure recovery to social stress in parentally bereaved and non-bereaved youths. J Psychosom Res 2018; 113:58-65. [PMID: 30190049 PMCID: PMC6157912 DOI: 10.1016/j.jpsychores.2018.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 07/13/2018] [Accepted: 07/26/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine differences in blood pressure response and recovery in a sample of bereaved and non-bereaved youths during an acute stress task conducted 5 years after time of parental death. METHODS One-hundred and ninety-two (n = 192) bereaved and non-bereaved offspring (ages 11-29) participated in an adaptation of the Trier Social Stress Task (TSST) 5-years after the time of parental death. Blood pressure measurements were collected before, during, and after the laboratory stress protocol. Mixed models for repeated measures were used to analyze the effects of bereavement status and course of psychiatric disorder in the 5-year period after parental death in both offspring and caregivers on blood pressure response; linear regression was used to examine these associations with blood pressure recovery. RESULTS Although there were no differences across groups in diastolic (DBP) or systolic blood pressure (SBP) response to stress, bereaved offspring demonstrated less SBP recovery to the TSST as compared to non-bereaved offspring. A significant interaction between bereavement status and race, and a marginally significant interaction between bereavement status and sex indicated poor SBP recovery for parentally bereaved racial/ethnic minority offspring as compared to parentally bereaved Caucasian offspring, and for parentally bereaved males compared to parentally bereaved females. CONCLUSIONS Parentally bereaved youths demonstrate blood pressure response to social stress tasks similar to that of non-bereaved youths, but parentally bereaved ethnic/racial minority youths and parentally bereaved males evidence a less complete recovery from the effects of stress. The health consequences of poor blood pressure recovery in bereaved youths are discussed.
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Affiliation(s)
- Laura J Dietz
- University of Pittsburgh at Johnstown, Johnstown, PA, United States.
| | | | - Nadine Melhem
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Giovanna Porta
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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109
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Loria AS, Spradley FT, Obi IE, Becker BK, De Miguel C, Speed JS, Pollock DM, Pollock JS. Maternal separation enhances anticontractile perivascular adipose tissue function in male rats on a high-fat diet. Am J Physiol Regul Integr Comp Physiol 2018; 315:R1085-R1095. [PMID: 30256681 DOI: 10.1152/ajpregu.00197.2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Clinical studies have shown that obesity negatively impacts large arteries' function. We reported that rats exposed to maternal separation (MatSep), a model of early life stress, display enhanced angiotensin II (ANG II)-induced vasoconstriction in aortic rings cleaned of perivascular adipose tissue (PVAT) under normal diet (ND) conditions. We hypothesized that exposure to MatSep promotes a greater loss of PVAT-mediated protective effects on vascular function and loss of blood pressure (BP) rhythm in rats fed a high-fat diet (HFD) when compared with controls. MatSep was performed in male Wistar-Kyoto rats from days 2 to 14 of life. Normally reared littermates served as controls. On ND, aortic rings from MatSep rats with PVAT removed showed increased ANG II-mediated vasoconstriction versus controls; however, rings from MatSep rats with intact PVAT displayed blunted constriction. This effect was exacerbated by an HFD in both groups; however, the anticontractile effect of PVAT was greater in MatSep rats. Acetylcholine-induced relaxation was similar in MatSep and control rats fed an ND, regardless of the presence of PVAT. HFD impaired aortic relaxation in rings without PVAT from MatSep rats, whereas the presence of PVAT improved relaxation in both groups. On an HFD, immunolocalization of vascular smooth muscle-derived ANG-(1-7) and PVAT-derived adiponectin abundances were increased in MatSep. In rats fed an HFD, 24-h BP and BP rhythms were similar between groups. In summary, MatSep enhanced the ability of PVAT to blunt the heightened ANG II-induced vasoconstriction and endothelial dysfunction in rats fed an HFD. This protective effect may be mediated via the upregulation of vasoprotective factors within the adipovascular axis.
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Affiliation(s)
- Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky , Lexington, Kentucky
| | - Frank T Spradley
- Department of Surgery, University of Mississippi Medical Center , Jackson, Mississippi
| | - Ijeoma E Obi
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Bryan K Becker
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Carmen De Miguel
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Joshua S Speed
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - David M Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.,Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Jennifer S Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.,Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia
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110
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Abstract
OBJECTIVE The complex relationship between psychosocial stress over the lifetime, psychological factors, and cardiometabolic risk is still poorly understood. Accordingly, our aims were (1) to independently assess the associations between childhood adversity, life-event stress in remote (earlier than the last 5 years), and recent adulthood and cardiometabolic risk, and (2) to determine the role of psychological factors including personality, coping, and depression in these associations. METHODS The sample included 2674 adults, aged 35 to 66 years, randomly selected from urban area. Participants underwent a physical examination including the assessment of obesity markers, blood pressure, and blood lipid and glucose levels. Stress during adulthood was determined using the severity scores of 52 stressful life events. Information on adverse childhood experiences and major depressive disorders was collected using semistructured interviews, whereas personality traits and coping mechanisms were evaluated through questionnaires. RESULTS Both childhood adversity and stress in remote adulthood were associated with elevated body mass index (β [95% confidence interval {CI}] = 0.249 [0.029 to 0.468]; 0.020 [0.006 to 0.034]), waist circumference (β [95% CI] = 0.061 [0.024 to 0.099]; 0.08 [0.04 to 0.11]), and the global cardiometabolic risk score (β [95% CI] = 0.278 [0.017 to 0.540]; 0.017 [0.001 to 0.033]) after adjustment for sociodemographic, lifestyle, and psychological factors. In addition, childhood adversity was associated with low high density lipoprotein levels (β [95% CI] = -0.021 [-0.042 to 0.000]), as well as increased fat mass and systolic blood pressure levels (β [95% CI] = 0.506 [0.165 to 0.846]; 0.952 [0.165 to 1.740]) and stress in remote adulthood with apolipoprotein B levels (β [95% CI] = 0.607 [0.312 to 0.901]). Psychological factors did not account for these associations and were not effect modifiers. CONCLUSIONS Our data demonstrate that psychosocial stress during childhood and remote adulthood favor adiposity and abnormal lipid metabolism.
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111
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Murphy MO, Herald JB, Leachman J, Villasante Tezanos A, Cohn DM, Loria AS. A model of neglect during postnatal life heightens obesity-induced hypertension and is linked to a greater metabolic compromise in female mice. Int J Obes (Lond) 2018; 42:1354-1365. [PMID: 29535450 PMCID: PMC6054818 DOI: 10.1038/s41366-018-0035-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 01/05/2018] [Accepted: 01/14/2018] [Indexed: 12/12/2022]
Abstract
.: Exposure to early life stress (ELS) is associated with behavioral-related alterations, increases in body mass index and higher systolic blood pressure in humans. Postnatal maternal separation and early weaning (MSEW) is a mouse model of neglect characterized by a long-term dysregulation of the neuroendocrine system. OBJECTIVES Given the contribution of adrenal-derived hormones to the development of obesity, we hypothesized that exposure to MSEW could contribute to the worsening of cardiometabolic function in response to chronic high-fat diet (HF) feeding by promoting adipose tissue expansion and insulin resistance. SUBJECTS MSEW was performed in C57BL/6 mice from postnatal days 2-16 and weaned at postnatal day 17. Undisturbed litters weaned at postnatal day 21 served as the control (C) group. At the weaning day, mice were placed on a low-fat diet (LF) or HF for 16 weeks. RESULTS When fed a LF, male and female mice exposed to MSEW display similar body weight but increased fat mass compared to controls. However, when fed a HF, only female MSEW mice display increased body weight, fat mass, and adipocyte hypertrophy compared with controls. Also, female MSEW mice display evidence of an early onset of cardiometabolic risk factors, including hyperinsulinemia, glucose intolerance, and hypercholesterolemia. Yet, both male and female MSEW mice fed a HF show increased blood pressure compared with controls. CONCLUSIONS This study shows that MSEW promotes a sex-specific dysregulation of the adipose tissue expansion and glucose homeostasis that precedes the development of obesity-induced hypertension.
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Affiliation(s)
- Margaret O Murphy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Joseph B Herald
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Jacqueline Leachman
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | | | - Dianne M Cohn
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA.
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112
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Li S, Chen W. Identifying elevated blood pressure and hypertension in children and adolescents. J Clin Hypertens (Greenwich) 2018; 20:515-517. [PMID: 29430812 PMCID: PMC6874101 DOI: 10.1111/jch.13222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Shengxu Li
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Wei Chen
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
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113
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Xie P, Wu K, Zheng Y, Guo Y, Yang Y, He J, Ding Y, Peng H. Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China. J Affect Disord 2018; 228:41-48. [PMID: 29223913 DOI: 10.1016/j.jad.2017.11.011] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/20/2017] [Accepted: 11/04/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Childhood trauma has long-term adverse effects on physical and psychological health. Previous studies demonstrated that suicide and mental disorders were related to childhood trauma. In China, there is insufficient research available on childhood trauma in patients with mental disorders. METHODS Outpatients were recruited from a psychiatric hospital in southern China, and controls were recruited from local communities. The demographic questionnaire, the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Social Support Rating Scale (SSRS) were completed by all participants, and the Self-rating Idea of Suicide Scale (SIOSS) were completed only by patients. Prevalence rates of childhood trauma were calculated. Kruskal-Wallis test and Dunnett test were used to compare CTQ-SF and SSRS scores between groups. Logistic regression was used to control demographic characteristics and examine relationships between diagnosis and CTQ-SF and SSRS scores. Spearman's rank correlation test was conducted to analyze relationships between suicidal ideation and childhood trauma and suicidal ideation and social support. RESULTS The final sample comprised 229 patients with depression, 102 patients with bipolar, 216 patient with schizophrenia, and 132 healthy controls. In our sample, 55.5% of the patients with depression, 61.8% of the patients with bipolar disorder, 47.2% of the patients with schizophrenia, and 20.5% of the healthy people reported at least one type of trauma. In patient groups, physical neglect (PN) and emotional neglect (EN) were most reported, and sexual abuse (SA) and physical abuse (PA) were least reported. CTQ-SF and SSRS total scores, and most of their subscale scores in patient groups were significantly different from the control group. After controlling demographic characteristics, mental disorders were associated with higher CTQ-SF scores and lower SSRS scores. CTQ-SF scores and number of trauma types were positively correlated with the SIOSS score. Negative correlations existed between SSRS scores and the SIOSS score. LIMITATIONS Our sample may not be sufficiently representative. Some results might have been interfered by demographic characteristics. The SIOSS was not completed by controls. Data from self-report scales were not sufficiently objective. CONCLUSIONS In southern China, childhood trauma is more severe and more prevalent in patients with mental disorders (depression, bipolar disorder and schizophrenia) than healthy people. Among patients with mental disorders in southern China, suicidal ideation is associated with childhood trauma and poor social support.
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Affiliation(s)
- Peng Xie
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yangbo Guo
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yuling Yang
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Jianfei He
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yi Ding
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Hongjun Peng
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China.
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114
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De Miguel C, Obi IE, Ho DH, Loria AS, Pollock JS. Early life stress induces immune priming in kidneys of adult male rats. Am J Physiol Renal Physiol 2018; 314:F343-F355. [PMID: 28971994 PMCID: PMC5899229 DOI: 10.1152/ajprenal.00590.2016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 12/31/2022] Open
Abstract
Early life stress (ELS) in humans is associated with elevated proinflammatory markers. We hypothesized that ELS induces activation of the immune response in a rat model of ELS, maternal separation (MatSep), in adulthood. MatSep involves separating pups from the dam from postnatal day 2 to postnatal day 14 for 3 h/day. Control rats are nonseparated littermates. We determined circulating and renal immune cell numbers, renal immune cell activation markers, renal cytokine levels, and the renal inflammatory gene expression response to low-dose lipopolysaccharide (LPS) in male MatSep and control rats. We observed that MatSep did not change the percentage of gated events for circulating CD3+, CD4+, CD8+, and CD4+/Foxp3+ cells or absolute numbers of mononuclear and T cells in the circulation and kidneys; however, MatSep led to an increase in activation of renal neutrophils as well as CD44+ cells. Renal toll-like receptor 4 (TLR4) and interleukin 1 beta (IL-1β) was significantly increased in MatSep rats, specifically in the outer and inner medulla and distal nephron, respectively. Evaluation of renal inflammatory genes showed that in response to a low-dose LPS challenge (2 mg/kg iv) a total of 20 genes were significantly altered in kidneys from MatSep rats (17 genes were upregulated and 3 were downregulated), as opposed to no significant differences in gene expression in control vs. control + LPS groups. Taken together, these findings indicate that MatSep induces priming of the immune response in the kidney.
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Affiliation(s)
- Carmen De Miguel
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Ijeoma E Obi
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Dao H Ho
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky , Lexington, Kentucky
| | - Jennifer S Pollock
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Department of Medicine, Augusta University , Augusta, Georgia
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115
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Anderson EL, Fraser A, Caleyachetty R, Hardy R, Lawlor DA, Howe LD. Associations of adversity in childhood and risk factors for cardiovascular disease in mid-adulthood. CHILD ABUSE & NEGLECT 2018; 76:138-148. [PMID: 29102868 PMCID: PMC5915314 DOI: 10.1016/j.chiabu.2017.10.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/16/2017] [Accepted: 10/30/2017] [Indexed: 05/04/2023]
Abstract
Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. The aim of this study is to assess associations of various types of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. At study enrolment, women from the Avon Longitudinal Study of Parents and Children (N=3612) retrospectively reported: lack of maternal care, maternal overprotection, parental mental illness, household dysfunction, sexual abuse, physical and emotional abuse, and neglect in childhood. Approximately 23 years later, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma glucose, insulin, triglycerides, low and high density lipoprotein cholesterol, C-reactive protein, carotid intima-media thickness (cIMT) and arterial distensibility were assessed (mean age 51 years). We examined associations of each specific type of psychosocial adversity and cumulative adversity with CVD risk factors. No specific type of psychosocial adversity was consistently associated with the CVD risk factors. There was evidence that a one standard deviation greater cumulative psychosocial adversity was associated with 0.51cm greater waist circumference (95% confidence interval [CI]: 0.02cm, 1.00cm, p=0.04) and a lower arterial distensibility, even after adjustment for age, ethnicity and childhood and adult socioeconomic position. We found no consistent evidence that any specific type of psychosocial adversity, or cumulative psychosocial adversity in childhood, is associated with CVD risk factors in adult women.
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Affiliation(s)
- Emma L Anderson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK.
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at University College London, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
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116
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Maternal verbally aggressive behavior in early infancy is associated with blood pressure at age 5–6. J Dev Orig Health Dis 2018; 9:344-350. [DOI: 10.1017/s2040174418000041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AbstractEarly life stress has been shown to contribute to alterations in biobehavioral regulation. Whereas many different forms of childhood adversities have been studied in relation to cardiovascular outcomes, very little is known about potential associations between caregivers’ verbally aggressive behavior and heart rate and blood pressure in the child. This prospective study examined whether maternal verbally aggressive behavior in early infancy is associated with heart rate or blood pressure at age 5–6. In the Amsterdam Born Children and their Development study, a large prospective, population-based birth cohort, maternal verbally aggressive behavior was assessed by questionnaire in the 13th week after birth. The child’s blood pressure and heart rate were measured during rest at age 5–6 (n=2553 included). Maternal verbally aggressive behavior in infancy was associated with a higher systolic blood pressure (SBP) both in supine and sitting position after adjustment for sex, height and age (SBP supine B=1.01 mmHg; 95% CI [0.06; 1.95] and SPB sitting B=1.29 mmHg; 95% CI [0.12; 2.46]). Adjustment for potential confounding variables, such as other mother–infant dyad aspects, family hypertension and child’s BMI, only slightly attenuated the associations (SBP supine B=0.99 mmHg; 95% CI [0.06; 1.93] and SPB sitting B=1.11 mmHg; 95% CI [−0.06; 2.27]). Maternal verbally aggressive behavior was not associated with diastolic blood pressure or heart rate at age 5–6. Maternal verbally aggressive behavior might be an important early life stressor with negative impact on blood pressure later in life, which should be further investigated. Possible underlying mechanisms are discussed.
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Suglia SF, Koenen KC, Boynton-Jarrett R, Chan PS, Clark CJ, Danese A, Faith MS, Goldstein BI, Hayman LL, Isasi CR, Pratt CA, Slopen N, Sumner JA, Turer A, Turer CB, Zachariah JP. Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association. Circulation 2017; 137:e15-e28. [PMID: 29254928 DOI: 10.1161/cir.0000000000000536] [Citation(s) in RCA: 286] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child's bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the United States, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. This statement also conceptually outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research to inform practice and policy. We note that, despite a lack of objective agreement on what subjectively qualifies as exposure to childhood adversity and a dearth of prospective studies, substantial evidence documents an association between childhood adversity and cardiometabolic outcomes across the life course. Future studies that focus on mechanisms, resiliency, and vulnerability factors would further strengthen the evidence and provide much-needed information on targets for effective interventions. Given that childhood adversities affect cardiometabolic health and multiple health domains across the life course, interventions that ameliorate these initial upstream exposures may be more appropriate than interventions remediating downstream cardiovascular disease risk factor effects later in life.
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118
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Body mass index trajectories in childhood is predictive of cardiovascular risk: results from the 23-year longitudinal Georgia Stress and Heart study. Int J Obes (Lond) 2017; 42:923-925. [PMID: 28978977 PMCID: PMC5886821 DOI: 10.1038/ijo.2017.244] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/17/2017] [Accepted: 09/15/2017] [Indexed: 12/22/2022]
Abstract
The childhood high body mass index (BMI) is associated with cardiovascular risk, but the association between childhood BMI trajectory patterns and cardiovascular risk remains unclear. The purposes of this study are to identify subgroups of individuals with similar trajectories in BMI during childhood, and to determine the relationship of childhood BMI trajectories with subclinical cardiovascular disease in young adulthood, indexed by intima-media thickness (IMT) and left ventricular mass index (LVMI). The participants were from the Georgia Stress and Heart (GSH) study. A total of 626 participants with BMI measured 3–12 times during childhood (5–18 years old) were included. By using latent class models, three trajectory groups in BMI were identified, including high increasing (HI), moderate increasing (MI), and normal group. We found that childhood trajectory of BMI was significantly associated with IMT and LVMI in young adulthood even after adjustment for BMI in young adulthood. Our results suggested that different BMI trajectory patterns exist during childhood. We for the first time reported the association between childhood BMI trajectory patterns and subclinical cardiovascular risk in young adulthood, indicating that monitoring trajectories of BMI from childhood may help to identify a high cardiovascular risk population in early life.
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119
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Anderson EL, Caleyachetty R, Stafford M, Kuh D, Hardy R, Lawlor DA, Fraser A, Howe LD. Prospective associations of psychosocial adversity in childhood with risk factors for cardiovascular disease in adulthood: the MRC National Survey of Health and Development. Int J Equity Health 2017; 16:170. [PMID: 28882142 PMCID: PMC5590112 DOI: 10.1186/s12939-017-0656-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. We aimed to assess associations of various forms of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. METHODS Participants were from the MRC National Survey of Health and Development. Childhood psychosocial risk factors were reported prospectively by parents from 1950-1957, and retrospectively by participants at mean age 43 years in 1989. CVD risk factors were assessed at mean age 60-64 years in 2006-2011. Associations of a summary score of total psychosocial adversity and CVD risk in adulthood were assessed. RESULTS There was no consistent evidence that cumulative psychosocial adversity, nor any specific form of psychosocial adversity in childhood, was associated with CVD risk factors in late adulthood. There was some evidence that parental death in the first 15 years was associated with higher SBP (Beta: 0.23, 95% confidence interval: 0.06 to 0.40, P=0.01) and DBP (Beta: 0.15, 95% confidence interval: -0.01 to 0.32, P=0.07). CONCLUSIONS We found no evidence that exposure to greater psychosocial adversity, or specific forms of psychosocial adversity during childhood is associated with adult CVD risk factors. Further large population studies are needed to clarify whether parental death is associated with higher systolic and diastolic blood pressure.
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Affiliation(s)
- Emma L. Anderson
- 0000 0004 1936 7603grid.5337.2MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- 0000 0004 1936 7603grid.5337.2School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Rishi Caleyachetty
- 0000 0004 1936 7486grid.6572.6The Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Mai Stafford
- 0000000121901201grid.83440.3bMRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Diana Kuh
- 0000000121901201grid.83440.3bMRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Rebecca Hardy
- 0000000121901201grid.83440.3bMRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Debbie A. Lawlor
- 0000 0004 1936 7603grid.5337.2MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- 0000 0004 1936 7603grid.5337.2School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Abigail Fraser
- 0000 0004 1936 7603grid.5337.2MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- 0000 0004 1936 7603grid.5337.2School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Laura D. Howe
- 0000 0004 1936 7603grid.5337.2MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- 0000 0004 1936 7603grid.5337.2School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
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Affiliation(s)
- Gary L Pierce
- From the Department of Health and Human Physiology (G.L.P.), Abboud Cardiovascular Research Center (G.L.P.), and UIHC Center for Hypertension Research (G.L.P.), The University of Iowa, Iowa City.
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Anderson EL, Heron J, Ben-Shlomo Y, Kuh D, Cooper R, Lawlor DA, Fraser A, Howe LD. Adversity in childhood and measures of aging in midlife: Findings from a cohort of british women. Psychol Aging 2017; 32:521-530. [PMID: 28891666 PMCID: PMC5592847 DOI: 10.1037/pag0000182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Very few studies have assessed whether socioeconomic and psychosocial adversity during childhood are associated with objective measures of aging later in life. We assessed associations of socioeconomic position (SEP) and total psychosocial adversity during childhood, with objectively measured cognitive and physical capability in women during midlife. Adverse childhood experiences were retrospectively reported at mean ages 28-30 years in women from the Avon Longitudinal Study of Parents And Children (N = 2,221). We investigated associations of childhood SEP and total psychosocial adversity, with composite measures of cognitive and physical capability at mean age 51 years. There was evidence that, compared with participants whose fathers had professional occupations, participants whose fathers had managerial/technical, skilled nonmanual, skilled manual, and partly or unskilled manual occupations had, on average, lower physical and cognitive capability. There was a clear trend for increasing magnitudes of association with lowering childhood SEP. There was also evidence that greater total psychosocial adversity in childhood was associated with lower physical capability. Total psychosocial adversity in childhood was not associated with cognitive capability. Lower SEP in childhood is detrimental to cognitive and physical capability in midlife, at least in part, independently of subsequent SEP in adulthood. Greater psychosocial adversity in childhood is associated with poorer physical capability, independently of social disadvantage in childhood. Our findings highlight the need for interventions to both identify and support children experiencing socioeconomic or psychosocial of adversity as early as possible. (PsycINFO Database Record
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Affiliation(s)
- Emma L Anderson
- Medical Research Council Integrative Epidemiology Unit, University of Bristol
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing, University College London
| | - Rachel Cooper
- Medical Research Council Unit for Lifelong Health and Ageing, University College London
| | - Debbie A Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol
| | - Abigail Fraser
- Medical Research Council Integrative Epidemiology Unit, University of Bristol
| | - Laura D Howe
- School of Social and Community Medicine, University of Bristol
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Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L, Dunne MP. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2017; 2:e356-e366. [PMID: 29253477 DOI: 10.1016/s2468-2667(17)30118-4] [Citation(s) in RCA: 2223] [Impact Index Per Article: 317.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. METHODS In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. FINDINGS Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I2 of >75%) between estimates for almost half of the outcomes. INTERPRETATION To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. FUNDING Public Health Wales.
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Affiliation(s)
- Karen Hughes
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK; Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK
| | - Mark A Bellis
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK; Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK.
| | - Katherine A Hardcastle
- Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK
| | - Dinesh Sethi
- World Health Organization Regional Office for Europe, Division of NonCommunicable Diseases and Promoting Health through the Life-Course, Copenhagen, Denmark
| | - Alexander Butchart
- World Health Organization, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, Geneva, Switzerland
| | - Christopher Mikton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Lisa Jones
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
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Lee RD, Chen J. Adverse childhood experiences, mental health, and excessive alcohol use: Examination of race/ethnicity and sex differences. CHILD ABUSE & NEGLECT 2017; 69:40-48. [PMID: 28448813 PMCID: PMC5896758 DOI: 10.1016/j.chiabu.2017.04.004] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/29/2017] [Accepted: 04/03/2017] [Indexed: 05/20/2023]
Abstract
Responses from N=60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types - household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5-2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups.
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Affiliation(s)
- Rosalyn D Lee
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS F-64, Atlanta, 30341, GA, United States.
| | - Jieru Chen
- Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, United States
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Abstract
OBJECTIVE Identifying the life course health effects of childhood adversity is a burgeoning area of research, particularly in relation to cardiovascular disease (CVD). However, adversity measurement varies widely across studies, which may hamper our ability to make comparisons across studies and identify mechanisms linking adversity to CVD. The purposes of this review are to summarize adversity measurement approaches in the context of CVD, identify gaps, and make recommendations for future research. METHODS PubMed and PsycINFO searches were conducted through June 2016. Studies were selected if CVD end point or predisease risk markers were investigated in association with a measure of childhood adversity. Forty-three studies were reviewed. A meta-analysis was not conducted because of the variation in exposures and outcomes assessed. RESULTS Adversity measurement was heterogeneous across studies. Metrics included different sets of adverse events, relational factors, and socioeconomic indicators. Thirty-seven percent measured childhood adversity prospectively, 23% examined a CVD end point, and 77% treated adversity as an unweighted summary score. Despite the heterogeneity in measurement, most studies found a positive association between childhood adversity and CVD risk, and the association seems to be dose-response. CONCLUSIONS The literature on childhood adversity and CVD would benefit from improving consistency of measurement, using weighted adversity composites, modeling adversity trajectories over time, and considering socioeconomic status as an antecedent factor instead of a component part of an adversity score. We suggest conceptual and analytic strategies to enhance, refine, and replicate the observed association between childhood adversity and CVD risk.
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125
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Basu A, McLaughlin KA, Misra S, Koenen KC. Childhood Maltreatment and Health Impact: The Examples of Cardiovascular Disease and Type 2 Diabetes Mellitus in Adults. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017; 24:125-139. [PMID: 28867878 DOI: 10.1111/cpsp.12191] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Child maltreatment is associated with increased risk for an array of mental and physical health problems. We reviewed studies examining associations of child maltreatment, assessed either alone or in combination with other adversities, with cardiovascular disease (CVD) and Type 2 Diabetes. PubMed was searched for relevant studies until December, 2015. Forty publications met inclusion criteria. Consistent positive associations were noted across a range of childhood adversities. Child maltreatment was associated with CVD (myocardial infarction, stroke, ischemic heart disease, coronary heart disease) in 91.7% of studies, with diabetes in 88.2% of studies, and with blood pressure/hypertension in 61.5% of studies. Inclusion of mental disorders tended to attenuate associations. Sex-related differences were under-examined. Implications for future research and intervention efforts are discussed.
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Affiliation(s)
- Archana Basu
- Harvard T. H. Chan School of Public Health, Massachusetts General Hospital
| | | | | | - Karestan C Koenen
- Harvard T. H. Chan School of Public Health, Massachusetts General Hospital
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126
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Loria AS, Osborn JL. Maternal separation diminishes α-adrenergic receptor density and function in renal vasculature from male Wistar-Kyoto rats. Am J Physiol Renal Physiol 2017; 313:F47-F54. [PMID: 28331064 DOI: 10.1152/ajprenal.00591.2016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/13/2017] [Accepted: 03/15/2017] [Indexed: 11/22/2022] Open
Abstract
Adult rats exposed to maternal separation (MatSep) are normotensive but display lower glomerular filtration rate and increased renal neuroadrenergic drive. The aim of this study was to determine the renal α-adrenergic receptor density and the renal vascular responsiveness to adrenergic stimulation in male rats exposed to MatSep. In addition, baroreflex sensitivity was assessed to determine a component of neural control of the vasculature. Using tissue collected from 4-mo-old MatSep and control rats, α1-adrenergic receptors (α1-ARs) were measured in renal cortex and isolated renal vasculature using receptor binding assay, and the α-AR subtype gene expression was determined by RT-PCR. Renal cortical α1-AR density was similar between MatSep and control tissues (Bmax = 44 ± 1 vs. 42 ± 2 fmol/mg protein, respectively); however, MatSep reduced α1-AR density in renal vasculature (Bmax = 47 ± 4 vs. 62 ± 4 fmol/mg protein, P < 0.05, respectively). In a separate group of rats, the pressor, bradycardic, and renal vascular constrictor responses to acute norepinephrine injection (NE, 0.03-0.25 μg/μl) were determined under anesthesia. Attenuated NE-induced renal vasoconstriction was observed in rats exposed to MatSep compared with control (P < 0.05). A third group of rats was infused at steady state with the α1 agonist phenylephrine (10 μg/min iv) and vasodilator sodium nitroprusside (5 μg/min iv). The difference between the change in heart rate/mean arterial pressure slopes was indicative of reduced baroreflex sensitivity in MatSep vs. control rats (-0.45 ± 0.04 vs. -0.95 ± 0.07 beats·min-1·mmHg-1, P < 0.05). These data support the notion that reduced α-adrenergic receptor expression and function in the renal vasculature could develop secondary to MatSep-induced overactivation of the renal neuroadrenergic tone.
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Affiliation(s)
- Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky; and
| | - Jeffrey L Osborn
- Department of Biology, University of Kentucky, Lexington, Kentucky
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127
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Murphy MO, Cohn DM, Loria AS. Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents. Neurosci Biobehav Rev 2017; 74:453-465. [PMID: 27450581 PMCID: PMC5250589 DOI: 10.1016/j.neubiorev.2016.07.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 02/07/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) hypothesizes that environmental insults during childhood programs the individual to develop chronic disease in adulthood. Emerging epidemiological data strongly supports that early life stress (ELS) given by the exposure to adverse childhood experiences is regarded as an independent risk factor capable of predicting future risk of cardiovascular disease. Experimental animal models utilizing chronic behavioral stress during postnatal life, specifically maternal separation (MatSep) provides a suitable tool to elucidate molecular mechanisms by which ELS increases the risk to develop cardiovascular disease, including hypertension. The purpose of this review is to highlight current epidemiological studies linking ELS to the development of cardiovascular disease and to discuss the potential molecular mechanisms identified from animal studies. Overall, this review reveals the need for future investigations to further clarify the molecular mechanisms of ELS in order to develop more personalized therapeutics to mitigate the long-term consequences of chronic behavioral stress including cardiovascular and heart disease in adulthood.
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Affiliation(s)
- M O Murphy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - D M Cohn
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - A S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States.
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128
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The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma. CHILDREN-BASEL 2017; 4:children4030016. [PMID: 28264496 PMCID: PMC5368427 DOI: 10.3390/children4030016] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 02/19/2017] [Accepted: 02/21/2017] [Indexed: 01/22/2023]
Abstract
Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.
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129
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Hao G, Wang X, Treiber FA, Harshfield G, Kapuku G, Su S. Blood Pressure Trajectories From Childhood to Young Adulthood Associated With Cardiovascular Risk: Results From the 23-Year Longitudinal Georgia Stress and Heart Study. Hypertension 2017; 69:435-442. [PMID: 28093467 DOI: 10.1161/hypertensionaha.116.08312] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 08/22/2016] [Accepted: 11/18/2016] [Indexed: 01/12/2023]
Abstract
The purpose of this study is to identify subgroups of individuals with similar trajectories in blood pressure (BP) from childhood to young adulthood and to determine the relationship of BP trajectories with carotid intima-media thickness (IMT) and left ventricular mass index (LVMI). BP was measured ≤16 times during a 23-year period in 683 participants from childhood to young adulthood. IMT and LVMI were measured in 551 participants and 546 participants, respectively. Using latent class models, 3 trajectory groups in BP from childhood to young adulthood were identified, including high-increasing, moderate-increasing, and low-increasing groups. We found that trajectory of systolic BP was a significant predictor of both IMT and LVMI with increased rate of growth in systolic BP associated with higher levels of IMT and LVMI (Pfor trend <0.001). Similar to the BP trajectory groups from childhood to young adulthood, 3 trajectory groups in BP during childhood (≤18 years) were identified, and participants in the high-increasing group had thicker IMT (P<0.001) and increased LVMI (P=0.043) in comparison with those in the low-increasing group. Results were similar for mid-BP trajectories but not for diastolic BP trajectories. Our results suggested that different BP trajectories exist from childhood to young adulthood, and the trajectories were independently associated with IMT and LVMI. We, for the first time, reported the association between systolic BP trajectories derived from childhood with subclinical cardiovascular risk in young adulthood, indicating that monitoring trajectories of BP from childhood may help identify a high cardiovascular risk population in early life.
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Affiliation(s)
- Guang Hao
- From the Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University (G.H., X.W., G.H., G.K., S.S.); and Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.)
| | - Xiaoling Wang
- From the Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University (G.H., X.W., G.H., G.K., S.S.); and Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.)
| | - Frank A Treiber
- From the Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University (G.H., X.W., G.H., G.K., S.S.); and Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.)
| | - Gregory Harshfield
- From the Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University (G.H., X.W., G.H., G.K., S.S.); and Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.)
| | - Gaston Kapuku
- From the Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University (G.H., X.W., G.H., G.K., S.S.); and Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.)
| | - Shaoyong Su
- From the Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University (G.H., X.W., G.H., G.K., S.S.); and Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.).
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130
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Youssef NA, Belew D, Hao G, Wang X, Treiber FA, Stefanek M, Yassa M, Boswell E, McCall WV, Su S. Racial/ethnic differences in the association of childhood adversities with depression and the role of resilience. J Affect Disord 2017; 208:577-581. [PMID: 27806896 PMCID: PMC5154886 DOI: 10.1016/j.jad.2016.10.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/06/2016] [Accepted: 10/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACE) including childhood abuse and trauma increase depressive symptoms. The role of resilience and how it interacts with both ACEs and the potential development of depressive symptoms, including how race and ethnicity moderate these effects, are much less studied. The aims of this study were to examine: 1) whether there is a dose-response relationship between trauma and depressive symptoms; 2) whether early trauma affected European Americans (EA) and African Americans (AA) in a similar fashion; and 3) whether resilience mitigates the effect of trauma. METHODS The present study comprised a cross-sectional study of subjects from a longitudinal cohort. All subjects were 19 years or older with traumatic experiences prior to age 18. Subjects were assessed for depressive symptoms as well as resilience. RESULTS In 413 subjects enrolled, ACEs were significantly associated with depression severity in a dose-response fashion (p<0.001). Notably, AAs had lower depression scores at low to moderate levels of ACEs than EAs, but reported comparable levels of depression with severe exposure to ACEs (pInteraction=0.05). In both EAs and AAs, young adults with high and medium levels of resilience showed less depressive symptoms compared to those with low resilience (p<0.05). LIMITATIONS to consider are the cross-sectional design, possibility of other confounders, and potential for recall bias of this study. CONCLUSION While ACEs were significantly associated with severity of depression in a dose-response fashion, higher resilience mitigated the impact of childhood adversities on depressive symptoms in young adults. The results are encouraging, and guides research for therapeutics to boost resilience.
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Affiliation(s)
- Nagy A Youssef
- Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Daniel Belew
- Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Guang Hao
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xiaoling Wang
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Frank A Treiber
- Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michael Stefanek
- Department of Psychological Sciences, College of Science and Mathematics, Augusta University, Augusta, GA, USA
| | - Mark Yassa
- Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Elizabeth Boswell
- Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - W Vaughn McCall
- Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shaoyong Su
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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131
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Hao G, Wang X, Treiber FA, Davis H, Leverett S, Su S, Kapuku G. Growth of Carotid Intima-Media Thickness in Black and White Young Adults. J Am Heart Assoc 2016; 5:JAHA.116.004147. [PMID: 27998916 PMCID: PMC5210407 DOI: 10.1161/jaha.116.004147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background There are few longitudinal studies that have comprehensively examined the intima‐media thickness (IMT) growth pattern and its determinants among racial population groups. Methods and Results Mean and maximum IMT were measured by B‐mode ultrasonography up to 3 times in 253 white and 268 black participants, aged 13 to 36 years (mean age±standard deviation 24±3.2 years old). The development of IMT was assessed using individual growth curve modeling. A total of 521 participants with 1015 IMT measurements were eligible for this study. We found higher IMT in both left and right sides in blacks compared to whites (P<0.001) in young adulthood. Both whites and blacks showed a strong linear increase in mean IMT with age. Body mass index and father's education level were associated with mean IMT, and only body mass index was associated with maximum IMT (P<0.05). We did not observe an interaction between age and race/ethnicity on the growth of IMT, suggesting that blacks and whites developed IMT in similar patterns. Interestingly, we found a faster increase in mean left‐side IMT than mean right‐side IMT (χ2=11.5, P<0.001) in both black and white subjects as well as in males and females. Conclusions Our findings provide compelling prospective evidence that blacks may have thicker IMT compared to whites as young adults. These racial differences could not be explained by traditional risk factors. This implies that differences in this precursor of atherosclerosis may explain racial disparity in cerebrovascular disease.
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Affiliation(s)
- Guang Hao
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Xiaoling Wang
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Frank A Treiber
- Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston, SC
| | - Harry Davis
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Sharika Leverett
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Shaoyong Su
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Gaston Kapuku
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
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132
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Kagura J, Adair LS, Munthali RJ, Pettifor JM, Norris SA. Association Between Early Life Growth and Blood Pressure Trajectories in Black South African Children. Hypertension 2016; 68:1123-1131. [PMID: 27672027 DOI: 10.1161/hypertensionaha.116.08046] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/23/2016] [Indexed: 11/16/2022]
Abstract
Early growth is associated with blood pressure measured on one occasion, but whether early life growth patterns are associated with longitudinal blood pressure trajectories is under-researched. Therefore, we sought to examine the association between early growth and blood pressure trajectories from childhood to adulthood. Blood pressure was measured on 7 occasions between ages 5 and 18 years in the Birth to Twenty cohort study, and conditional variables for growth in infancy and mid-childhood were computed from anthropometric measures (n=1937, 52% girls). We used a group-based trajectory modeling approach to identify distinct height-adjusted blood pressure trajectories and then tested their association with growth between birth and mid-childhood adjusting for several covariates. Three trajectory groups were identified for systolic and diastolic blood pressure: lower, middle, and upper in boys and girls, separately. In boys, predictors of the middle or upper systolic blood pressure trajectories versus the lower trajectory were in birth weight (odds ratio 0.75 [95% confidence interval 0.58-0.96] per SD) and relative weight gain in infancy (4.11 [1.25-13.51] per SD). In girls, greater relative weight gain and linear growth in both infancy and mid-childhood were consistently associated with an almost 2-fold higher likelihood of being in the upper versus lower systolic blood pressure trajectory. The associations for the diastolic blood pressure trajectories were inconsistent. These findings emphasize the importance of identifying children at risk of progression to high blood pressure. Accelerated growth in infancy and mid-childhood may be a key target for early life intervention in prevention of elevated blood pressure progression.
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Affiliation(s)
- Juliana Kagura
- From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.).
| | - Linda S Adair
- From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.)
| | - Richard J Munthali
- From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.)
| | - John M Pettifor
- From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.)
| | - Shane A Norris
- From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.)
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133
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Su S, Jimenez MP, Roberts CTF, Loucks EB. The role of adverse childhood experiences in cardiovascular disease risk: a review with emphasis on plausible mechanisms. Curr Cardiol Rep 2016; 17:88. [PMID: 26289252 DOI: 10.1007/s11886-015-0645-1] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Childhood adversity, characterized by abuse, neglect, and household dysfunction, is a problem that exerts a significant impact on individuals, families, and society. Growing evidence suggests that adverse childhood experiences (ACEs) are associated with health decline in adulthood, including cardiovascular disease (CVD). In the current review, we first provide an overview of the association between ACEs and CVD risk, with updates on the latest epidemiological evidence. Second, we briefly review plausible pathways by which ACEs could influence CVD risk, including traditional risk factors and novel mechanisms. Finally, we highlight the potential implications of ACEs in clinical and public health. Information gleaned from this review should help physicians and researchers in better understanding potential long-term consequences of ACEs and considering adapting current strategies in treatment or intervention for patients with ACEs.
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Affiliation(s)
- Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, 1120 15th Street, HS 1721, Augusta, GA, 30912, USA,
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134
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Magnussen CG, Smith KJ. Pediatric Blood Pressure and Adult Preclinical Markers of Cardiovascular Disease. Clin Med Insights Blood Disord 2016; 9:1-8. [PMID: 27168729 PMCID: PMC4857790 DOI: 10.4137/cmbd.s18887] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/06/2016] [Accepted: 04/08/2016] [Indexed: 01/27/2023]
Abstract
A high blood pressure level in adults is considered the single most important modifiable risk factor for global disease burden, especially those of cardiovascular (CV) origin such as stroke and ischemic heart disease. Because blood pressure levels have been shown to persist from childhood to adulthood, elevations in pediatric levels have been hypothesized to lead to increased CV burden in adulthood and, as such, might provide a window in the life course where primordial and primary prevention could be focused. In the absence of substantive data directly linking childhood blood pressure levels to overt adult CV disease, this review outlines the available literature that examines the association between pediatric blood pressure and adult preclinical markers of CV disease.
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Affiliation(s)
- Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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135
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Gupta-Malhotra M, Hashmi SS, Barratt MS, Milewicz DM, Shete S. Childhood-Onset Essential Hypertension and the Family Structure. J Clin Hypertens (Greenwich) 2016; 18:431-8. [PMID: 26435293 PMCID: PMC4821812 DOI: 10.1111/jch.12701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/31/2015] [Accepted: 08/07/2015] [Indexed: 11/28/2022]
Abstract
The prevalence and effect of single-parent families in childhood-onset essential hypertension (EH) is unknown. Children with EH and age-, sex-, and ethnicity-matched controls were enrolled. Family structure data were obtained by in-person interview. A total of 148 families (76 hypertension probands, 72 control probands; median 14 years) were prospective-ly enrolled in the study. Single-parent status was seen in 42% of the families--with and without EH (38% vs 46%, P=.41; odds ratio, 0.7; 95% confidence interval, 0.4-1.4). After multivariable analysis, a statistically significant sociofamilial contributor to the development of childhood-onset EH was not identified. A significant number of single-parent families (42%), the majority with single mothers, were found in our pedigree study. Sociofamilial factors are known to contribute to the expression of adult-onset EH, but findings in our study suggest that they appear to contribute less in the expression of childhood-onset EH.
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Affiliation(s)
- Monesha Gupta-Malhotra
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Memorial Hermann Hospital, The University of Texas Health Science Center, Houston, TX
| | - Syed Shahrukh Hashmi
- Pediatric Research Center, Department of Pediatrics, The University of Texas Health Science Center, Houston, TX
| | - Michelle S Barratt
- Divisions of Community and General Pediatrics and Adolescent Medicine, Department of Pediatrics, Children's Memorial Hermann Hospital, The University of Texas Health Science Center, Houston, TX
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center, Houston, TX
| | - Sanjay Shete
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas Health Science Center, Houston, TX
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136
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Wise PH. Child Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging. Acad Pediatr 2016; 16:S37-45. [PMID: 27044700 DOI: 10.1016/j.acap.2016.01.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 02/07/2023]
Abstract
The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This literature review focused on evidence of the influence of child poverty on the major contributors to adult morbidity and mortality in the United States, the mechanisms by which these associations operate, and the implications for reforming child health programs and policies. Strong and varied evidence base documents the effect of child poverty and related early life experiences and exposures on the major threats to adult health and healthy aging. Studies using a variety of methodologies, including longitudinal and cross-sectional strategies, have reported significant findings regarding cardiovascular disorders, obesity and diabetes, certain cancers, mental health conditions, osteoporosis and fractures, and possibly dementia. These relationships can operate through alterations in fetal and infant development, stress reactivity and inflammation, the development of adverse health behaviors, the conveyance of child chronic illness into adulthood, and inadequate access to effective interventions in childhood. Although the reviewed studies document meaningful relationships between child poverty and adult outcomes, they also reveal that poverty, experiences, and behaviors in adulthood make important contributions to adult health and aging. There is strong evidence that poverty in childhood contributes significantly to adult health. Changes in the content, financing, and advocacy of current child health programs will be required to address the childhood influences on adult health and disease. Policy reforms that reduce child poverty and mitigate its developmental effects must be integrated into broader initiatives and advocacy that also attend to the health and well-being of adults.
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Affiliation(s)
- Paul H Wise
- March of Dimes Center for Prematurity Research, the Division of Neonatology, Department of Pediatrics, School of Medicine, and the Centers for Health Policy/Primary Care and Outcomes Research, Stanford University, Calif.
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137
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Ho DH, Burch ML, Musall B, Musall JB, Hyndman KA, Pollock JS. Early life stress in male mice induces superoxide production and endothelial dysfunction in adulthood. Am J Physiol Heart Circ Physiol 2016; 310:H1267-74. [PMID: 26921433 DOI: 10.1152/ajpheart.00016.2016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/24/2016] [Indexed: 02/07/2023]
Abstract
Early life stress (ELS) is a risk for cardiovascular disease in adulthood although very little mechanistic insight is available. Because oxidative stress and endothelial dysfunction are major contributors to cardiovascular risk, we hypothesized that ELS induces endothelial dysfunction in adult male mice via increased superoxide production. Studies employed a mouse model of ELS, maternal separation with early weaning (MSEW), in which litters were separated from the dam for 4 h/day [postnatal days (PD) 2-5] and 8 h/day (PD6-16), and weaned at PD17. Control litters remained undisturbed until weaning at PD21. When compared with control mice, thoracic aortic rings from adult male MSEW mice displayed significant endothelial dysfunction that was reversed by the superoxide scavenger, polyethylene glycol-superoxide dismutase (PEG-SOD). PEG-SOD-inhibitable superoxide production by aortae from MSEW mice was significantly greater than observed in control aortae, although unaffected by nitric oxide synthase inhibition, suggesting that uncoupled nitric oxide synthase was not responsible for the accelerated superoxide production. Aortic SOD expression, plasma SOD activity, and total antioxidant activity were similar in MSEW and control mice, indicating unaltered antioxidant capacity in MSEW mice. Increased expression of the NADPH oxidase subunits, NOX2 and NOX4, was evident in the aortae of MSEW mice. Moreover, endothelial dysfunction and superoxide production in MSEW mice was reversed with the NADPH oxidase inhibitor, apocynin, indicating increased NADPH oxidase-dependent superoxide production and endothelial dysfunction. The finding that MSEW induces superoxide production and endothelial dysfunction in adult mice may provide a mechanistic link between ELS and adult cardiovascular disease risk.
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Affiliation(s)
- Dao H Ho
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Mariah L Burch
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Medicine, Augusta University, Augusta, Georgia
| | - Benjamin Musall
- Department of Medicine, Augusta University, Augusta, Georgia
| | | | - Kelly A Hyndman
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Jennifer S Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Medicine, Augusta University, Augusta, Georgia
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138
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Reho JJ, Fisher SA. The stress of maternal separation causes misprogramming in the postnatal maturation of rat resistance arteries. Am J Physiol Heart Circ Physiol 2015; 309:H1468-78. [PMID: 26371173 DOI: 10.1152/ajpheart.00567.2015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/03/2015] [Indexed: 11/22/2022]
Abstract
We examined the effect of stress in the first 2 wk of life induced by brief periods of daily maternal separation on developmental programming of rat small resistance mesenteric arteries (MAs). In MAs of littermate controls, mRNAs encoding mediators of vasoconstriction, including the α1a-adrenergic receptor, smooth muscle myosin heavy chain, and CPI-17, the inhibitory subunit of myosin phosphatase, increased from after birth through sexual [postnatal day (PND) 35] and full maturity, up to ∼80-fold, as measured by quantitative PCR. This was commensurate with two- to fivefold increases in maximum force production to KCl depolarization, calcium, and the α-adrenergic agonist phenylephrine, and increasing systolic blood pressure. Rats exposed to maternal separation stress as neonates had markedly accelerated trajectories of maturation of arterial contractile gene expression and function measured at PND14 or PND21 (weaning), 1 wk after the end of the stress protocol. This was suppressed by the α-adrenergic receptor blocker terazosin (0.5 mg·kg ip(-1)·day(-1)), indicating dependence on stress activation of sympathetic signaling. Due to the continued maturation of MAs in control rats, by sexual maturity (PND35) and into adulthood, no differences were observed in arterial function or response to a second stressor in rats stressed as neonates. Thus early life stress misprograms resistance artery smooth muscle, increasing vasoconstrictor function and blood pressure. This effect wanes in later stages, suggesting plasticity during arterial maturation. Further studies are indicated to determine whether stress in different periods of arterial maturation may cause misprogramming persisting through maturity and the potential salutary effect of α-adrenergic blockade in suppression of this response.
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Affiliation(s)
- John J Reho
- Departments of Medicine (Cardiovascular Medicine) and Physiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven A Fisher
- Departments of Medicine (Cardiovascular Medicine) and Physiology, University of Maryland School of Medicine, Baltimore, Maryland
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139
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Howe LD, Tilling K, Lawlor DA. Studying the life course health consequences of childhood adversity: challenges and opportunities. Circulation 2015; 131:1645-7. [PMID: 25858195 DOI: 10.1161/circulationaha.115.016251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Laura D Howe
- From MRC Integrative Epidemiology Unit and School of Social and Community Medicine, University of Bristol, United Kingdom
| | - Kate Tilling
- From MRC Integrative Epidemiology Unit and School of Social and Community Medicine, University of Bristol, United Kingdom
| | - Debbie A Lawlor
- From MRC Integrative Epidemiology Unit and School of Social and Community Medicine, University of Bristol, United Kingdom.
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