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Pantell MS, Silveira PP, de Mendonça Filho EJ, Wing H, Brown EM, Keeton VF, Pokhvisneva I, O'Donnell KJ, Neuhaus J, Hessler D, Meaney MJ, Adler NE, Gottlieb LM. Associations between Social Adversity and Biomarkers of Inflammation, Stress, and Aging in Children. Pediatr Res 2024; 95:1553-1563. [PMID: 38233512 PMCID: PMC11126389 DOI: 10.1038/s41390-023-02992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/17/2023] [Accepted: 11/11/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Prior work has found relationships between childhood social adversity and biomarkers of stress, but knowledge gaps remain. To help address these gaps, we explored associations between social adversity and biomarkers of inflammation (interleukin-1β [IL-1β], IL-6, IL-8, tumor necrosis factor-alpha [TNF-α], and salivary cytokine hierarchical "clusters" based on the three interleukins), neuroendocrine function (cortisol, cortisone, dehydroepiandrosterone, testosterone, and progesterone), neuromodulation (N-arachidonoylethanolamine, stearoylethanolamine, oleoylethanolamide, and palmitoylethanolamide), and epigenetic aging (Pediatric-Buccal-Epigenetic clock). METHODS We collected biomarker samples of children ages 0-17 recruited from an acute care pediatrics clinic and examined their associations with caregiver-endorsed education, income, social risk factors, and cumulative adversity. We calculated regression-adjusted means for each biomarker and compared associations with social factors using Wald tests. We used logistic regression to predict being in the highest cytokine cluster based on social predictors. RESULTS Our final sample included 537 children but varied based on each biomarker. Cumulative social adversity was significantly associated with having higher levels of all inflammatory markers and with cortisol, displaying a U-shaped distribution. There were no significant relationships between cumulative social adversity and cortisone, neuromodulation biomarkers or epigenetic aging. CONCLUSION Our findings support prior work suggesting that social stress exposures contribute to increased inflammation in children. IMPACT Our study is one of the largest studies examining associations between childhood social adversity and biomarkers of inflammation, neuroendocrine function, neuromodulation, and epigenetic aging. It is one of the largest studies to link childhood social adversity to biomarkers of inflammation, and the first of which we are aware to link cumulative social adversity to cytokine clusters. It is also one of the largest studies to examine associations between steroids and epigenetic aging among children, and one of the only studies of which we are aware to examine associations between social adversity and endocannabinoids among children. CLINICAL TRIAL REGISTRATION NCT02746393.
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Affiliation(s)
- Matthew S Pantell
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California, San Francisco, CA, USA.
- Center for Health and Community, University of California, San Francisco, San Francisco, CA, USA.
- Social Interventions Research and Evaluation Network, University of California, San Francisco, CA, USA.
| | - Patricia P Silveira
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Euclides José de Mendonça Filho
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Holly Wing
- Center for Health and Community, University of California, San Francisco, San Francisco, CA, USA
- Social Interventions Research and Evaluation Network, University of California, San Francisco, CA, USA
| | | | - Victoria F Keeton
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 490 Illinois St, Box 2930, 94143, San Francisco, CA, USA
| | - Irina Pokhvisneva
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
| | - Kieran J O'Donnell
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Yale Child Study Center & Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Danielle Hessler
- Social Interventions Research and Evaluation Network, University of California, San Francisco, CA, USA
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Michael J Meaney
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Republic of Singapore
| | - Nancy E Adler
- Center for Health and Community, University of California, San Francisco, San Francisco, CA, USA
| | - Laura M Gottlieb
- Center for Health and Community, University of California, San Francisco, San Francisco, CA, USA
- Social Interventions Research and Evaluation Network, University of California, San Francisco, CA, USA
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
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Qu G, Liu H, Ma S, Han T, Zhang H, Sun L, Qin Q, Chen M, Sun Y. Inflammatory burden of adolescents with childhood maltreatment: results from baseline data of a school cohort. Eur Child Adolesc Psychiatry 2024; 33:539-548. [PMID: 36877251 DOI: 10.1007/s00787-023-02181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
Increasing studies have investigated inflammatory burden of adults with childhood adversity, but less is known about how childhood maltreatment affects the inflammation level of adolescents. Baseline data of a school cohort of physical and mental health status and life experience survey on primary and secondary school students in Anhui Province, China was used. Childhood maltreatment of children and adolescents was assessed by Chinese version of Childhood Trauma Questionnaire-Short Form (CTQ-SF). Urine samples were collected to assess levels of soluble urokinase Plasminogen Activator Receptor (suPAR), C-reactive protein (CRP) and cytokines interleukin-6 (IL-6) by enzyme-linked immunosorbent assay (ELISA). Logistic regression was conducted to examine the association between childhood maltreatment exposure and risk of high inflammation burden. A total of 844 students were included with mean age 11.41 ± 1.57 years old. Adolescents with emotional abuse were significantly more likely to have high level of IL-6 (OR = 3.59, 95% CI 1.16-11.14). In addition, adolescents with emotional abuse were more likely to show high IL-6 and high suPAR combination (OR = 33.41, 95% CI 1.69-659.22), and high IL-6 and low CRP combination (OR = 4.34, 95% CI 1.29-14.55). Subgroup analyses showed that emotional abuse was associated with high IL-6 burden among boys or adolescents with depression. Childhood emotional abuse was positively associated with higher burden of IL-6. Early detection and prevention of emotional abuse for children and adolescents, especially for boys or adolescents with depression status, may be helpful for preventing elevated inflammatory burden and related health problems.
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Affiliation(s)
- Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tiantian Han
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Huimei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, No.19, Zhongnan Avenue, Fuyang, 236000, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, No.849, Jiangdong Avenue, Ma'anshan, 243000, Anhui, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Changfeng, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, Hefei, 238000, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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3
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Lange K, Pham C, Fedyszyn IE, Cook F, Burgner DP, Olsson CA, Downes M, Priest N, Mansell T, Tang MLK, Ponsonby AL, Symeonides C, Loughman A, Vuillermin P, Kerr JA, Gray L, Sly PD, Lycett K, Carlin JB, Saffery R, Wake M, O'Connor M. Emotional symptoms and inflammatory biomarkers in childhood: Associations in two Australian birth cohorts. J Affect Disord 2024; 344:356-364. [PMID: 37832736 DOI: 10.1016/j.jad.2023.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/11/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND An increasing body of evidence supports associations between inflammation and mental health difficulties, but the onset and directionality of these relationships are unclear. METHODS Data sources: Barwon Infant Study (BIS; n = 500 4-year-olds) and Longitudinal Study of Australian Children (LSAC; n = 1099 10-13-year-olds). MEASURES Strengths and Difficulties Questionnaire emotional symptoms at 4, 10-11 and 12-13 years, and circulating levels of two inflammatory biomarkers, high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA), at 4 and 11-12 years. ANALYSIS Adjusted quantile regression models examining cross-sectional associations between emotional symptoms and inflammation in 4-year-olds (BIS), and cross-lagged associations in 10-13-year-olds (LSAC). RESULTS We identified a small association between higher emotional symptoms at 10-11 years and higher GlycA levels a year later (standardised coefficient β = 0.09; 95%CI: 0.02 to 0.15). Sex-stratified analyses revealed this association was stronger for boys (β = 0.13; 95%CI: 0.04 to 0.21) than girls (β = 0.01; 95%CI: -0.09 to 0.11). These associations were not observed for hsCRP. There was little evidence of an association between higher GlycA or hsCRP at 11-12 years and emotional symptoms a year later, or cross-sectional associations between emotional symptoms and hsCRP or GlycA at 4 years. LIMITATIONS A single time-point of biomarker collection in late childhood precluded adjustment for baseline inflammatory biomarkers. CONCLUSIONS Our results support the direction of association from emotional symptoms to inflammation in late childhood, with potential sex differences. This adds to the body of evidence that addressing emotional symptoms in childhood is a major priority in optimising overall health throughout the life course.
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Affiliation(s)
- Katherine Lange
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia.
| | - Cindy Pham
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia
| | - Izabela E Fedyszyn
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Melbourne School of Population and Global Health, Parkville, VIC, Australia
| | - Fallon Cook
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - David P Burgner
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia; Monash University, Department of Paediatrics, Clayton, VIC, Australia
| | - Craig A Olsson
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia; Deakin University, Centre for Social and Early Emotional Development, Faculty of Health, School of Psychology, Burwood, VIC, Australia
| | - Marnie Downes
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Naomi Priest
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Australian National University, Centre for Social Research and Methods, Canberra, ACT, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Melbourne School of Population and Global Health, Parkville, VIC, Australia; University of Melbourne, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Christos Symeonides
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Royal Children's Hospital, Parkville, VIC, Australia; Minderoo Foundation, Perth, WA, Australia
| | - Amy Loughman
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Geelong, VIC, Australia
| | - Peter Vuillermin
- Deakin University, School of Medicine, Geelong, VIC, Australia; Barwon Health, Child Health Research Unit, Geelong, VIC, Australia
| | - Jessica A Kerr
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia; University of Otago, Department of Psychological Medicine, Christchurch, New Zealand
| | - Lawrence Gray
- Deakin University, School of Medicine, Geelong, VIC, Australia; Barwon Health, Child Health Research Unit, Geelong, VIC, Australia
| | - Peter D Sly
- University of Queensland, Child Health Research Centre, South Brisbane, QLD, Australia
| | - Kate Lycett
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia; Deakin University, Centre for Social and Early Emotional Development, Faculty of Health, School of Psychology, Burwood, VIC, Australia
| | - John B Carlin
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia; University of Auckland, Liggins Institute, Grafton, Auckland, New Zealand
| | - Meredith O'Connor
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia; University of Melbourne, Melbourne Graduate School of Education, Parkville, VIC, Australia
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Priest N, Guo S, Gondek D, O'Connor M, Moreno-Betancur M, Gray S, Lacey R, Burgner DP, Woolfenden S, Badland H, Redmond G, Juonala M, Lange K, Goldfeld S. The potential of intervening on childhood adversity to reduce socioeconomic inequities in body mass index and inflammation among Australian and UK children: A causal mediation analysis. J Epidemiol Community Health 2023; 77:632-640. [PMID: 37536921 PMCID: PMC10527996 DOI: 10.1136/jech-2022-219617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/19/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Lower maternal education is associated with higher body mass index (BMI) and higher chronic inflammation in offspring. Childhood adversity potentially mediates these associations. We examined the extent to which addressing childhood adversity could reduce socioeconomic inequities in these outcomes. METHODS We analysed data from two early-life longitudinal cohorts: the Longitudinal Study of Australian Children (LSAC; n=1873) and the UK Avon Longitudinal Study of Parents and Children (ALSPAC; n=7085). EXPOSURE low/medium (below university degree) versus high maternal education, as a key indicator of family socioeconomic position (0-1 year). OUTCOMES BMI and log-transformed glycoprotein acetyls (GlycA) (LSAC: 11-12 years; ALSPAC: 15.5 years). Mediator: multiple adversities (≥2/<2) indicated by family violence, mental illness, substance abuse and harsh parenting (LSAC: 2-11 years; ALSPAC: 1-12 years). A causal mediation analysis was conducted. RESULTS Low/medium maternal education was associated with up to 1.03 kg/m2 higher BMI (95% CI: 0.95 to 1.10) and up to 1.69% higher GlycA (95% CI: 1.68 to 1.71) compared with high maternal education, adjusting for confounders. Causal mediation analysis estimated that decreasing the levels of multiple adversities in children with low/medium maternal education to be like their high maternal education peers could reduce BMI inequalities by up to 1.8% and up to 3.3% in GlycA. CONCLUSIONS Our findings in both cohorts suggest that slight reductions in socioeconomic inequities in children's BMI and inflammation could be achieved by addressing childhood adversities. Public health and social policy efforts should help those affected by childhood adversity, but also consider underlying socioeconomic conditions that drive health inequities.
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Affiliation(s)
- Naomi Priest
- Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory, Australia
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dawid Gondek
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Meredith O'Connor
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Children's LifeCourse Initiative, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Victoria, Australia
| | - Margarita Moreno-Betancur
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sarah Gray
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Lacey
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - David P Burgner
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- Department of General Medicine, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Sue Woolfenden
- Population Child Health Research Group, University of New South Wales, Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Hannah Badland
- Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
| | - Gerry Redmond
- College of Business, Government and Law, Flinders University, Adelaide, South Australia, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Katherine Lange
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Molecular Immunity Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Sominsky L, O'Hely M, Drummond K, Cao S, Collier F, Dhar P, Loughman A, Dawson S, Tang ML, Mansell T, Saffery R, Burgner D, Ponsonby AL, Vuillermin P. Pre-pregnancy obesity is associated with greater systemic inflammation and increased risk of antenatal depression. Brain Behav Immun 2023; 113:189-202. [PMID: 37437818 DOI: 10.1016/j.bbi.2023.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Pre-pregnancy obesity is an emerging risk factor for perinatal depression. However, the underlying mechanisms remain unclear. We investigated the association between pre-pregnancy body mass index (BMI) and perinatal depressive symptoms in a large population-based pre-birth cohort, the Barwon Infant Study. We also assessed whether the levels of circulating inflammatory markers during pregnancy mediated this relationship. METHODS Depressive symptoms were assessed in 883 women using the Edinburgh Postnatal Depression Scale (EPDS) and psychological stress using the Perceived Stress Scale (PSS) at 28 weeks gestation and 4 weeks postpartum. Glycoprotein acetyls (GlycA), high-sensitivity C-reactive protein (hsCRP) and cytokines were assessed at 28 weeks gestation. We performed regression analyses, adjusted for potential confounders, and investigated mediation using nested counterfactual models. RESULTS The estimated effect of pre-pregnancy obesity (BMI ≥ 30 kg/m2) on antenatal EPDS scores was 1.05 points per kg/m2 increase in BMI (95% CI: 0.20, 1.90; p = 0.02). GlycA, hsCRP, interleukin (IL) -1ra and IL-6 were higher in women with obesity, compared to healthy weight women, while eotaxin and IL-4 were lower. Higher GlycA was associated with higher EPDS and PSS scores and partially mediated the association between pre-pregnancy obesity and EPDS/PSS scores in unadjusted models, but this association attenuated upon adjustment for socioeconomic adversity. IL-6 and eotaxin were negatively associated with EPDS/PSS scores, however there was no evidence for mediation. CONCLUSIONS Pre-pregnancy obesity increases the risk of antenatal depressive symptoms and is also associated with systemic inflammation during pregnancy. While discrete inflammatory markers are associated with antenatal depressive symptoms and perceived stress, their role in mediating the effects of pre-pregnancy obesity on antenatal depression requires further investigation.
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Affiliation(s)
- Luba Sominsky
- Barwon Health, Geelong, Victoria, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia.
| | - Martin O'Hely
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katherine Drummond
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Sifan Cao
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Fiona Collier
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Poshmaal Dhar
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Samantha Dawson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Mimi Lk Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Vuillermin
- Barwon Health, Geelong, Victoria, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
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Wang X, Fu K. Long-term effects of early adversity on the mental health of college students: The mitigating effect of physical exercise. Front Psychol 2023; 14:1102508. [PMID: 36874870 PMCID: PMC9975709 DOI: 10.3389/fpsyg.2023.1102508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
Background We aim to investigate the long-term effects of early adversity on university students' mental health and the mitigating role of physical exercise on this effect. Methods The survey sample consisted of 895 college students. Descriptive statistics, linear regression, and moderating effect analysis were used to analyze the results. Results (1) Early adversity negatively predict mental health level (β = -0.109, t = -4.981, p < 0.01); (2) Physical exercise can effectively mitigate the long-term harm of early adversity to mental health (β = 0.039, t = 2.001, p < 0.05); compared to low-level physical exercise (b simple = -0. 067, t = -7.88, p < 0.01), high-level physical exercise can mitigate the long-term harm of early adversity to mental health (b simple = -0, 025, t = -2. 37, p < 0.01). Conclusion Early adversity affects the mental health of university students, but physical exercise can effectively mitigate this effect.
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Affiliation(s)
- Xinzhu Wang
- School of Teacher Education, Xichang University, Xichang, Sichuan, China
| | - Kaixian Fu
- Development Planning Division, Xichang University, Xichang, Sichuan, China
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7
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The effect of adverse and positive experiences on inflammatory markers in Australian and UK children. Brain Behav Immun Health 2022; 26:100550. [PMID: 36420372 PMCID: PMC9677086 DOI: 10.1016/j.bbih.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
Abstract
Background The relationship between childhood adversity and inflammation is well-established. Examination of positive experiences can provide a more complete understanding of intervention opportunities. We investigated associations of adverse and positive experiences, and their intersection, with inflammation in children and adolescents. Methods Data sources: Longitudinal Study of Australian Children (LSAC; N = 1237) and Avon Longitudinal Study of Parents and Children (ALSPAC; N = 3488). Exposures: Adverse and positive experiences assessed repeatedly (LSAC: 0-11 years; ALSPAC: 0-15 years). Outcomes: Inflammation quantified by high sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA) (LSAC: 11-12 years; ALSPAC: 15.5 years). Analyses: Linear regression on the log-transformed outcomes estimated the relative difference in inflammatory markers with adverse/positive experiences, adjusting for socio-demographics and concurrent positive/adverse experiences, respectively. Results Most associations were in the expected direction but differed in magnitude by exposure, outcome and cohort. Across both cohorts, adverse experiences were associated with up to 7.3% higher hsCRP (95% CI: -18.6%, 33.2%) and up to 2.0% higher GlycA (95% CI: 0.5%, 3.5%); while positive experiences were associated with up to 22.1% lower hsCRP (95% CI: -49.0%, 4.7%) and 1.3% lower GlycA (95% CI: -2.7%, 0.2%). In LSAC, the beneficial effect of positive experiences on inflammation was more pronounced among those with fewer concurrent adverse experiences. Conclusion Across two cohorts, we found small but directionally consistent associations between adverse experiences and higher inflammation, and positive experiences and lower inflammation, particularly for GlycA. Future research should give further consideration to positive experiences to complement the current focus on adversity and inform the design and evaluation of early life interventions.
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O'Connor M, Spry E, Patton G, Moreno-Betancur M, Arnup S, Downes M, Goldfeld S, Burgner D, Olsson CA. Better together: Advancing life course research through multi-cohort analytic approaches. ADVANCES IN LIFE COURSE RESEARCH 2022; 53:100499. [PMID: 36652217 DOI: 10.1016/j.alcr.2022.100499] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 06/22/2022] [Accepted: 07/15/2022] [Indexed: 06/17/2023]
Abstract
Longitudinal cohorts can provide timely and cost-efficient evidence about the best points of health service and preventive interventions over the life course. Working systematically across cohorts has the potential to further exploit these valuable data assets, such as by improving the precision of estimates, enhancing (or appropriately reducing) confidence in the replicability of findings, and investigating interrelated questions within a broader theoretical model. In this conceptual review, we explore the opportunities and challenges presented by multi-cohort approaches in life course research. Specifically, we: 1) describe key motivations for multi-cohort work and the analytic approaches that are commonly used in each case; 2) flag some of the scientific and pragmatic challenges that arise when adopting these approaches; and 3) outline emerging directions for multi-cohort work in life course research. Harnessing their potential while thoughtfully considering limitations of multi-cohort approaches can contribute to the robust and granular evidence base needed to promote health and wellbeing over the life span.
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Affiliation(s)
- Meredith O'Connor
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia.
| | - Elizabeth Spry
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia; Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - George Patton
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia
| | - Sarah Arnup
- Murdoch Children's Research Institute, Parkville, Australia
| | - Marnie Downes
- Murdoch Children's Research Institute, Parkville, Australia
| | - Sharon Goldfeld
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia; Royal Children's Hospital, Centre for Community Child Health, Parkville, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia; Royal Children's Hospital, Department of General Medicine, Parkville, Australia; Monash University, Department of Pediatrics, Clayton, Australia
| | - Craig A Olsson
- Murdoch Children's Research Institute, Parkville, Australia; University of Melbourne, Department of Paediatrics, Parkville, Australia; Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
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9
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Pham C, Bekkering S, O'Hely M, Burgner D, Thomson S, Vuillermin P, Collier F, Marx W, Mansell T, Symeonides C, Sly PD, Tang MLK, Saffery R, Ponsonby AL. Infant inflammation predicts childhood emotional and behavioral problems and partially mediates socioeconomic disadvantage. Brain Behav Immun 2022; 104:83-94. [PMID: 35618227 DOI: 10.1016/j.bbi.2022.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Emotional and behavioral problems (EBP) are common in children. Environmental factors like socioeconomic disadvantage influence EBP pathogenesis and can trigger inflammation. However, the link between early inflammation-EBP in children is unclear. We investigated the associations between i) infant inflammatory biomarkers and subsequent EBP and ii) early life environmental factors and EBP and assessed whether infant inflammation mediated these associations. METHODS Inflammatory biomarkers glycoprotein acetyls (GlycA) and high-sensitivity C-reactive protein (hsCRP) were quantified at birth and 12 months in a population-derived birth cohort, the Barwon Infant Study. Early life factors including demographic, prenatal, and perinatal factors were collected from antenatal to the two-year period. Internalizing and externalizing problems at age two were measured by the Child Behavior Checklist. Prospective associations were examined by multivariable regression analyses adjusted for potential confounders. Indirect effects of early life factors on EBP through inflammation were identified using mediation analyses. RESULTS Elevated GlycA levels at birth (GlycAbirth) were associated with greater internalizing problems at age two (β = 1.32 per SD increase in GlycA; P = 0.001). Inflammation at birth had a stronger magnitude of effect with later EBP than at 12 months. GlycAbirth partially mediated the associations between lower household income (6%), multiparity (12%) and greater number of older siblings (13%) and EBP. Patterns were less evident for hsCRP or externalizing problems. CONCLUSIONS GlycAbirth was positively associated with EBP at age two and partially mediated the association between several indicators of socioeconomic disadvantage and EBP. Prenatal and perinatal inflammation may be relevant to early neurodevelopment and emotional health.
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Affiliation(s)
- Cindy Pham
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia; Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Siroon Bekkering
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, GA 6625, the Netherlands
| | - Martin O'Hely
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Sarah Thomson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
| | - Peter Vuillermin
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia; Barwon Health, Geelong, VIC 3220, Australia
| | - Fiona Collier
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia; Barwon Health, Geelong, VIC 3220, Australia
| | - Wolfgang Marx
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia; School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Christos Symeonides
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Peter D Sly
- Child Health Research Centre, University of Queensland, South Brisbane, QLD 4101, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia; Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia.
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10
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O'Connor M, Moreno-Betancur M, Goldfeld S, Wake M, Patton G, Dwyer T, Tang MLK, Saffery R, Craig JM, Loke J, Burgner D, Olsson CA. Data Resource Profile: Melbourne Children's LifeCourse initiative (LifeCourse). Int J Epidemiol 2022; 51:e229-e244. [PMID: 35536352 PMCID: PMC9557929 DOI: 10.1093/ije/dyac086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/07/2022] [Indexed: 12/22/2022] Open
Affiliation(s)
- Meredith O'Connor
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Sharon Goldfeld
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Liggins Institute, University of Auckland, Grafton, Auckland, New Zealand
| | - George Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Terence Dwyer
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Jeffrey M Craig
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Jane Loke
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - David Burgner
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Inflammatory Origins Group, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Australia.,Department of Pediatrics, Monash University, Melbourne, Australia
| | - Craig A Olsson
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Australia
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11
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Iob E, Lacey R, Giunchiglia V, Steptoe A. Adverse childhood experiences and severity levels of inflammation and depression from childhood to young adulthood: a longitudinal cohort study. Mol Psychiatry 2022; 27:2255-2263. [PMID: 35241782 PMCID: PMC9126802 DOI: 10.1038/s41380-022-01478-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/24/2022] [Accepted: 02/08/2022] [Indexed: 12/26/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with depression and systemic inflammation in adults. However, limited longitudinal research has tested these relationships in children and young people, and it is unclear whether inflammation is an underlying mechanism through which ACEs influence depression. We examined the longitudinal associations of several ACEs across different early-life periods with longitudinal patterns of early-life inflammation and depression in young adulthood and assessed the mediating role of inflammation. The data came from the Avon Longitudinal Study of Parents and Children (N = 3931). ACEs from the prenatal period through to adolescence were operationalised using cumulative scores, single adversities, and dimensions derived through factor analysis. Inflammation (C-reactive protein) was measured on three occasions (9-18 years) and depressive symptoms were ascertained on four occasions (18-23 years). Latent class growth analysis was employed to delineate group-based trajectories of inflammation and depression. The associations between ACEs and the inflammation/depression trajectories were tested using multinomial logistic regression analysis. Most types of ACEs across all early-life periods were associated with elevated depression trajectories, with larger associations for threat-related adversities compared with other ACEs. Bullying victimisation and sexual abuse in late childhood/adolescence were associated with elevated CRP trajectories, while other ACEs were unrelated to inflammation. Inflammation was also unrelated to depression and did not mediate the associations with ACEs. These results suggest that ACEs are consistently associated with depression, whereas the associations of inflammation with ACEs and depression are weak in young people. Interventions targeting inflammation in this population might not offer protection against depression.
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Affiliation(s)
- Eleonora Iob
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Rebecca Lacey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Valentina Giunchiglia
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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12
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Crick DCP, Halligan SL, Howe LD, Lacey RE, Khandaker GM, Burgner D, Herbert A, Suderman M, Anderson EL, Fraser A. Associations between Adverse Childhood Experiences and the novel inflammatory marker glycoprotein acetyls in two generations of the Avon Longitudinal Study of Parents and Children birth cohort. Brain Behav Immun 2022; 100:112-120. [PMID: 34793940 PMCID: PMC8791601 DOI: 10.1016/j.bbi.2021.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/20/2021] [Accepted: 11/05/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with increased risk of non-communicable diseases in adulthood, potentially mediated by chronic low-grade inflammation. Glycoprotein acetyls (GlycA) is a marker of chronic and cumulative inflammation. We investigated associations between ACEs and GlycA at different ages, in two generations of the population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. METHODS ALSPAC offspring's total ACE scores were generated for two age periods using prospectively collected data: 0-7y and 0-17y. GlycA was measured using high-resolution proton nuclear magnetic resonance at mean ages 8y, 18y, and 24y. Sample sizes ranged from: n = 5116 (8y) to n = 3085 (24y). ALSPAC mothers (n = 4634) retrospectively reported ACEs experienced before age 18y and GlycA was assessed at mean age 49y. We used multivariable linear regression to estimate associations between ACEs (total ACE score and individual ACEs) and subsequent GlycA in both samples, adjusting for key confounders. RESULTS Mean GlycA levels were similar in offspring and mothers and over time. In offspring, there was no evidence that ACEs (total score or individual ACE) were associated with GlycA at age 8y or 18y, or 24y after adjustment for maternal age at birth and parity, maternal marital status, household occupational social class, maternal education, maternal smoking, own ethnicity, sex, and age in months. In mothers, there was evidence of a positive association between the total ACE score and GlycA at age 49y (adjusted mean difference 0.007 mmol/L; 95%CI: 0.003, 0.01). Emotional neglect was the only individual ACE associated with higher GlycA after adjusting for confounders and other ACEs. CONCLUSION Results suggest the association between ACEs and GlycA may emerge in middle age. Future research should explore the extent to which inflammation in adulthood mediates well-documented associations between ACEs and adverse health outcomes in later life.
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Affiliation(s)
- Daisy C P Crick
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK; Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Laura D Howe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rebecca E Lacey
- Research Department of Epidemiology and Public Health, UCL, London, UK
| | - Golam M Khandaker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - David Burgner
- Murdoch Children's Research Institute (MCRI), the Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Annie Herbert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Matthew Suderman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Emma L Anderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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13
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Priest N. How does the social environment become embodied to influence health and health inequalities? Brain Behav Immun 2021; 94:23-24. [PMID: 33607234 DOI: 10.1016/j.bbi.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
- Naomi Priest
- ANU Centre for Social Research and Methods, Australian National University, Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
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