1
|
Qiao Y, Zhu D, Zhao M, Magnussen CG, Xi B. Adverse childhood experience, adopting a healthy lifestyle in adulthood, and risk of cardiovascular diseases. J Affect Disord 2024; 362:450-458. [PMID: 39009308 DOI: 10.1016/j.jad.2024.07.023] [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: 01/02/2024] [Revised: 06/03/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Both adverse childhood experiences (ACEs) and lifestyle factors have been associated with risk of cardiovascular diseases (CVDs) in later life, but whether and to what extent adherence to a healthy lifestyle in adulthood can offset the increased cardiovascular risk associated with ACEs is unclear. We aimed to determine whether and to what extent adopting to a healthy lifestyle in adulthood can offset the risk of CVDs in individuals according to their ACEs. METHODS A prospective cohort study included 143,869 participants aged 38-72 years, free of CVDs at baseline from the UK Biobank. The history of ACEs was assessed using the Childhood Trauma Screener. Participants were divided into three risk groups based on ACEs: low (no ACEs), intermediate (one or two ACEs), and high (three or more ACEs). A healthy lifestyle score in adulthood was constructed as the sum of four modifiable lifestyle factors (no smoking, adequate physical activity, healthy diet, no obesity), and participants were then categorized into three groups based on this score (unfavorable [0-1 point], intermediate [2-3 points], favorable [4 points]). Cox proportional hazard models were conducted to investigate the association between ACEs, healthy lifestyle, and incident CVDs. RESULTS During a median follow-up of 12.49 years, 13,373 incident cases of overall CVDs were identified. This included 7521 cases of coronary heart disease (CHD), 6175 cases of atrial fibrillation (AF) and 1813 cases of stroke. Individuals with high ACEs had a greater risk of incident overall CVDs (hazard ratio [HR] = 1.39, [95%CI = 1.29 to 1.50]), CHD (1.50 [1.36 to 1.65]) and AF (1.18 [1.05 to 1.33]) compared to those with low ACEs. The risk of CVDs decreased moving from unfavorable to favorable lifestyle categories (P for trend<0.001), with the lowest risk observed among individuals with a favorable lifestyle (0.70 [0.66 to 0.74] for overall CVDs, 0.69 [0.64 to 0.75] for CHD, and 0.71 [0.65 to 0.78] for AF). Participants with high ACEs and a favorable lifestyle had a 39 %, 40 % and 47 % lower risk of developing overall CVDs (0.61 [0.48 to 0.76]), CHD (0.60 [0.44 to 0.81], and AF (0.53 [0.36 to 0.77]) than those with high ACEs and an unfavorable lifestyle. CONCLUSIONS Having a healthy lifestyle in adulthood could substantially attenuate the increased risk of overall CVDs, CHD, and AF conferred by ACEs.
Collapse
Affiliation(s)
- Yanan Qiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
| |
Collapse
|
2
|
Palatnic L, Kim JA, Kim SY, Moras E, Cagle-Colon K, Kapp DS, Krittanawong C. Human Papillomavirus as Nontraditional Cardiovascular Risk Factor: Fact or Fiction? Part 2. Am J Med 2024:S0002-9343(24)00481-9. [PMID: 39103007 DOI: 10.1016/j.amjmed.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 08/07/2024]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and worldwide, with more than 42 million Americans infected with types of HPV that are known to cause disease. While the link between HPV and the development of a variety of cancers has been strongly established, recent literature has demonstrated a potential association between HPV and increased risk of cardiovascular disease. Nevertheless, despite plausible mechanisms for the development of cardiovascular disease with HPV infection, a causative relationship has yet to be firmly established, in part due to potential confounding risk factors between the two. In this 2-part series, we discuss the emerging relationship between HPV and cardiovascular disease. In part 2, we focus on novel risk factors for HPV infection and cardiovascular disease including adverse childhood events, socioeconomic status, and immunosuppression. We conclude with potential prevention and treatment strategies for HPV-related cardiovascular disease, as well as the future direction of the research.
Collapse
Affiliation(s)
- Leonard Palatnic
- Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Jitae A Kim
- Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Sophie Y Kim
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, El Paso
| | - Errol Moras
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kayla Cagle-Colon
- Department of Obstetrics and Gynecology, Cherokee Nation Health Services, Tahlequah, OK
| | - Daniel S Kapp
- Department of Radiation Oncology, Stanford University, Calif
| | | |
Collapse
|
3
|
Bigot M, Guy JM, Monpere C, Cohen-Solal A, Pavy B, Iliou MC, Bosser G, Corone S, Douard H, Farrokhi T, Guerder A, Guillo P, Houppe JP, Pezel T, Pierre B, Roueff S, Thomas D, Verges B, Blanchard JC, Ghannem M, Marcadet D. Cardiac rehabilitation recommendations of the Group Exercise Rehabilitation Sports - Prevention (GERS-P) of the French Society of Cardiology: 2023 update. Arch Cardiovasc Dis 2024:S1875-2136(24)00217-1. [PMID: 39174436 DOI: 10.1016/j.acvd.2024.05.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 08/24/2024]
Affiliation(s)
- Muriel Bigot
- Centre de réadaptation cardiaque, Cardiocéan, 17138 Puilboreau, France.
| | - Jean Michel Guy
- Le Clos Champirol rééducation, 42270 Saint-Priest-en-Jarez, France
| | | | - Alain Cohen-Solal
- Service de cardiologie, centre de réadaptation cardiaque, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Inserm UMRS-942, université Paris Cité, 75010 Paris, France
| | - Bruno Pavy
- Service de réadaptation cardiovasculaire, CH Loire Vendée Océan, 44270 Machecoul, France
| | - Marie Christine Iliou
- Centre de réadaptation cardiaque, groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - Gilles Bosser
- Service de cardiologie pédiatrique et congénitale, CHU Nancy, 54600 Vandœuvre-Lès-Nancy, France
| | - Sonia Corone
- Service réadaptation cardiaque, centre hospitalier de Bligny, 91640 Briis-sous-Forges, France
| | | | - Titi Farrokhi
- Service réadaptation cardiaque, centre hospitalier de Bligny, 91640 Briis-sous-Forges, France
| | - Antoine Guerder
- Service de pneumologie, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
| | - Pascal Guillo
- Centre de réadaptation Saint-Yves, 35000 Rennes, France
| | | | - Theo Pezel
- Service de cardiologie, hôpital Lariboisière, AP-HP, université Paris Est Créteil, 75010 Paris, France
| | | | - Stephane Roueff
- Service de néphrologie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - Daniel Thomas
- Institut de cardiologie Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | | | | | - Mohamed Ghannem
- Service de cardiologie, hôpital de Gonesse, faculté de médecine, Sousse, Tunisia; Université Picardie Jules-Verne, 80000 Amiens, France
| | | |
Collapse
|
4
|
Migeot J, Panesso C, Duran-Aniotz C, Ávila-Rincón C, Ochoa C, Huepe D, Santamaría-García H, Miranda JJ, Escobar MJ, Pina-Escudero S, Romero-Ortuno R, Lawlor B, Ibáñez A, Lipina S. Allostasis, health, and development in Latin America. Neurosci Biobehav Rev 2024; 162:105697. [PMID: 38710422 PMCID: PMC11162912 DOI: 10.1016/j.neubiorev.2024.105697] [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: 10/24/2023] [Revised: 03/05/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.
Collapse
Affiliation(s)
- Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Carolina Panesso
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Cristian Ávila-Rincón
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia
| | - Carolina Ochoa
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Hernando Santamaría-García
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia
| | - J Jaime Miranda
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Josefina Escobar
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Stefanie Pina-Escudero
- Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, USA
| | - Roman Romero-Ortuno
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
| | - Sebastián Lipina
- Unidad de Neurobiología Aplicada (UNA, CEMIC-CONICET), Buenos Aires, Argentina.
| |
Collapse
|
5
|
Ding K, Lei M. From the early scars to the vicissitudes of old age: A bibliometric analysis revealing childhood adversity and aging. Psychoneuroendocrinology 2024; 165:107038. [PMID: 38609808 DOI: 10.1016/j.psyneuen.2024.107038] [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: 01/09/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Adversity suffered in childhood may profoundly affect aging over the subsequent life cycle. The field of childhood adversity and aging has amassed a certain number of publications, but there are no bibliometric studies in this field. METHODS Publications in 10 years on childhood adversity and aging were searched in the Web of Science Core Collection. Bibliometric tools were used to analyze and visualize these publications by country, institution, journal, author, keyword, research area, and co-citation. RESULTS Four hundred thirty-five publications were retrieved from 2014 to September 21, 2023, with a 4.9% annual growth rate. The United States (251), University of California, San Francisco (59), Elissa S. Epel (11), and Psychoneuroendocrinology (29) were the countries, institutions, authors, and journals contributing the highest number of publications in this field, respectively. "Early-life stress" (87), "depression" (82), "childhood trauma" (69), and "aging" (60) were the keywords that appeared more frequently. CONCLUSIONS This is the first bibliometric study on childhood adversity and aging. The United States dominates the field regarding publication numbers, research institutions, and researchers. Publications in this field are interdisciplinary, covering several critical subject areas and having far-reaching impacts, with gerontology, neurosciences, psychology, and psychiatry at the core.
Collapse
Affiliation(s)
- Kaixi Ding
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Ming Lei
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
| |
Collapse
|
6
|
Jennings EA, Mall S, Bassil DT, Kahn K. Exposure to Adversity and its Impact on Later Life Cognitive, Mental, and Physical Health. Int J Public Health 2024; 69:1606499. [PMID: 38961855 PMCID: PMC11219567 DOI: 10.3389/ijph.2024.1606499] [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: 08/10/2023] [Accepted: 05/29/2024] [Indexed: 07/05/2024] Open
Abstract
Objectives We aimed to assess later-life health responses to childhood and lifetime adversity in a cohort of rural, Black South African adults. Methods We performed ordinary least squares regression using two waves of data from Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) to estimate a decline in cognitive, mental, and physical health over approximately 3 years. Our analytic sample consisted of 1,993 women and 1,496 men. Results Associations between several types of adversity and health outcomes point to declines in health. At the same time, many adverse experiences are associated with improvements in cognitive, mental, and physical health in later life. The direction of the association varied by type of exposure, health outcome, and gender. Conclusion In populations exposed to many adversities during life, specific adverse experiences may sometimes be associated with greater improvements (and not just greater decline) in health in later life. Further research is needed to unpack the mechanisms at play in these populations.
Collapse
Affiliation(s)
- Elyse A. Jennings
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Darina T. Bassil
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
7
|
von Känel R, Princip M, Holzgang SA, Giannopoulos AA, Kaufmann PA, Buechel RR, Zuccarella-Hackl C, Pazhenkottil AP. Cross-sectional study on the impact of adverse childhood experiences on coronary flow reserve in male physicians with and without occupational burnout. J Psychosom Res 2024; 181:111672. [PMID: 38636300 DOI: 10.1016/j.jpsychores.2024.111672] [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: 01/20/2024] [Revised: 04/13/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Physicians face documented challenges to their mental and physical well-being, particularly in the forms of occupational burnout and cardiovascular disease. This study examined the previously under-researched intersection of early life stressors, prolonged occupational stress, and cardiovascular health in physicians. METHODS Participants were 60 practicing male physicians, 30 with clinical burnout, defined by the Maslach Burnout Inventory, and 30 non-burnout controls. They completed the Adverse Childhood Experiences (ACE) Questionnaire asking about abuse, neglect and household dysfunctions before the age of 18, and the Perceived Stress Scale to rate thoughts and feelings about stress in the past month. Endothelium-independent (adenosine challenge) coronary flow reserve (CFR) and endothelium-dependent CFR (cold pressor test) were assessed by positron emission tomography-computed tomography. The segment stenosis score was determined by coronary computed tomography angiography. RESULTS Twenty-six (43%) participants reported at least one ACE and five (8%) reported ≥4 ACEs. A higher ACEs sum score was associated with lower endothelium-independent CFR (r partial (rp) = -0.347, p = .01) and endothelium-dependent CFR (rp = -0.278, p = .04), adjusting for age, body mass index, perceived stress and segment stenosis score. In exploratory analyses, participants with ≥4 ACEs had lower endothelium-independent CFR (rp = -0.419, p = .001) and endothelium-dependent CFR (rp = -0.278, p = .04), than those with <4 ACEs. Endothelium-dependent CFR was higher in physicians with burnout than in controls (rp = 0.277, p = .04). No significant interaction emerged between burnout and ACEs for CFR. CONCLUSION The findings suggest an independent association between ACEs and CFR in male physicians and emphasize the nuanced relationship between early life stressors, professional stress, and cardiovascular health.
Collapse
Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
8
|
Kulak MJ, Lewis-de los Angeles W, Daniels TE, Mathis KJ, Gobin AP, Laumann LE, Beck Q, Tyrka AR. Increased Cardiometabolic Risk in Healthy Young Adults With Early Life Stress. Psychosom Med 2024; 86:72-82. [PMID: 38153259 PMCID: PMC10922275 DOI: 10.1097/psy.0000000000001273] [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] [Indexed: 12/29/2023]
Abstract
OBJECTIVE This study aimed to evaluate the relationship between early life stress (ELS) and metabolic risk in healthy young adults and assess the role of health behaviors. METHODS Young adults aged 18 to 40 years ( N = 190) with no medical conditions or medication usage were recruited from the community. Participants with ELS ( N = 113) had a history of childhood maltreatment, and most also experienced parental loss ( n = 88). Controls ( N = 77) had no history of maltreatment or parental loss. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Blood pressure and anthropometrics were measured, and fasting plasma assayed for lipid profiles, glucose, insulin level, and hemoglobin A 1c . We calculated both a clinical cut-point and continuous composite metabolic risk score based on clinical risk factors and the mean of z scores of each measure, respectively. RESULTS ELS was significantly associated with increased clinical cut-point ( β = 0.68, 95% confidence interval [CI] = 0.20-1.17, p = .006) and continuous ( β = 0.23, 95% CI = 0.08-0.038, p = .003) composite metabolic risk scores. On sensitivity analysis, the association of ELS with the continuous composite metabolic risk score was reduced to a trend after adjusting for a range of psychosocial and health predictors ( β = 0.18, 95% CI = 0.00-0.36, p = .053), with both diet and college graduate status significant in the model. CONCLUSIONS Healthy young adults with a history of ELS have increased metabolic risk scores as compared with controls. This relationship may be partially due to health behaviors and socioeconomic factors. These findings underline that ELS is an early contributor to metabolic risk.
Collapse
Affiliation(s)
- Meghan J. Kulak
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - William Lewis-de los Angeles
- Department of Pediatrics, Hasbro Children’s Hospital and Bradley Hospital, RI, USA
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Teresa E. Daniels
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Karen J. Mathis
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- University of Rhode Island College of Nursing, Kingston, RI
| | - Asi P. Gobin
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Laura E. Laumann
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Quincy Beck
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Audrey R. Tyrka
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| |
Collapse
|
9
|
Rogers EM, Banks NF, Jenkins NDM. The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review. Diabetes Metab Res Rev 2024; 40:e3667. [PMID: 37269143 DOI: 10.1002/dmrr.3667] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
Sleep deficiency is a ubiquitous phenomenon among Americans. In fact, in the United States, ∼78% of teens and 35% of adults currently get less sleep than recommended for their age-group, and the quality of sleep appears to be getting worse for many. The consequences of sleep disruption manifest in a myriad of ways, including insulin resistance and disrupted nutrient metabolism, dysregulation of hunger and satiety, and potentially increased body weight and adiposity. Consequently, inadequate sleep is related to an increased risk of various cardiometabolic diseases, including obesity, diabetes, and heart disease. Exercise has the potential to be an effective therapeutic to counteract the deleterious effects of sleep disruption listed above, whereas chronic psychosocial stress may causally promote sleep disruption and cardiometabolic risk. Here, we provide a narrative review of the current evidence on the consequences of short sleep duration and poor sleep quality on substrate metabolism, circulating appetite hormones, hunger and satiety, and weight gain. Secondly, we provide a brief overview of chronic psychosocial stress and its impact on sleep and metabolic health. Finally, we summarise the current evidence regarding the ability of exercise to counteract the adverse metabolic health effects of sleep disruption. Throughout the review, we highlight areas where additional interrogation and future exploration are necessary.
Collapse
Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
- Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
10
|
Mendoza ID, Banda JA, Giano Z, Hubach RD. Association between adverse childhood experiences and fruit and vegetable intake among a national sample of U.S. adults. Prev Med Rep 2023; 35:102339. [PMID: 37576841 PMCID: PMC10413147 DOI: 10.1016/j.pmedr.2023.102339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Few studies have examined the role adverse childhood experiences (ACEs) have on specific diet patterns. This study assessed the association between ACEs and daily fruit and vegetable intake (FVI). Data were derived from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) which surveys 50 states and three U.S. territories. Participants who completed the ACEs module were included in the analyses (N = 106,967). Total ACEs included the summed responses from the domains of abuse, household challenges, and neglect. FVI was reported by number of times consumed per day. The two fruit items included fruit (fresh, frozen, and canned) and fruit juice. The four vegetable items included leafy greens, fried potatoes, non-fried potatoes, and other vegetables. All fruit and vegetable items were analyzed separately to see which specific items drove the relationship between total ACEs and total FVI, equaling a total of 8 regression models. Every model controlled for poor mental health days, sex, age, ethnicity, income, body mass index, and physical activity. Total ACEs were positively associated with daily intake of fried potatoes (β = 0.008, p =.025), other potatoes (β = 0.008, p =.049), and other vegetables (β = 0.024, p <.001). Total ACEs were negatively associated with daily intake of fruit (β = -0.016, p <.001). ACEs had non-significant relationships with leafy greens and fruit juice. Findings suggests that those with increased ACEs scores report increased consumption of fried potatoes, non-fried potatoes, and other vegetables, and less of fruit. Findings highlight the need for understanding food context and preparation when analyzing the relationship between ACEs and diet intake.
Collapse
Affiliation(s)
- Ivan D. Mendoza
- Department of Public Health, Purdue University, 812 W State St., West Lafayette, IN 47907, USA
| | - Jorge A. Banda
- Department of Public Health, Purdue University, 812 W State St., West Lafayette, IN 47907, USA
| | - Zachary Giano
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Randolph D. Hubach
- Department of Public Health, Purdue University, 812 W State St., West Lafayette, IN 47907, USA
| |
Collapse
|
11
|
Wang W, Liu Y, Yang Y, Jiang W, Ni Y, Han X, Lu C, Guo L. Adverse childhood and adulthood experiences and risk of new-onset cardiovascular disease with consideration of social support: a prospective cohort study. BMC Med 2023; 21:297. [PMID: 37553602 PMCID: PMC10408183 DOI: 10.1186/s12916-023-03015-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The relationship between adverse childhood experiences (ACEs) and adverse adulthood experiences (AAEs) and their association with incident cardiovascular disease (CVD) have not been extensively studied. Considering social support, we evaluated the complex relations of ACEs and AAEs with incident CVD. METHODS This prospective cohort study used data from the 2014 life course survey and the 2015 and 2018 surveys of the China Health and Retirement Longitudinal Study, a national survey of Chinese adults aged ≥ 45 years from 28 provinces across China. The study population included 5836 individuals (mean [SD] age, 59.59 [8.22] years, 49.7% were males). Information on ACEs, AAEs, young adulthood social support, health behavior factors, health status factors, and demographics was measured. Cox regression models, the difference method to estimate the mediation proportion, and the additive and multiplicative interactions were performed. Subgroup and sensitivity analyses were also conducted. RESULTS During follow-up, 789 incident cases of CVD occurred. The fully adjusted model, including demographics, health behaviors, health status factors (e.g., depressive symptoms), and social support as control variables, demonstrated that the overall number of ACEs (Hazard ratio [HR]: 1.11, 95% CI: 1.08 to 1.14) and AAEs (HR: 1.19, 95% CI: 1.16 to 1.22) were associated with an increased risk of incident CVD. A dose-response relationship existed between the number of ACEs or AAEs and incident CVD risk. The overall AAEs were found to mediate 17.7% (95% CI: 8.2 to 34.2%) of the association between ACEs and incident CVD. Moreover, a significant additive interaction between ACEs and AAEs was detected (RERI [95% CI]: 0.32 [0.09 to 0.56]). Compared with adults without exposure to both ACE and AAE, those with exposure to both at least one ACE and one AAE indicator had the highest risk of incident CVD (HR: 1.96, 95% CI: 1.72 to 2.23). CONCLUSIONS Exposure to ACEs or AAEs was independently associated with an increased risk of incident CVD among Chinese middle-aged and older adults in a dose-response manner, and the overall AAEs partially mediated the association between ACEs and incident CVD. Preventive measures aimed at addressing either ACEs or AAEs alone may not significantly reduce the risk of CVD later in life. The necessity of a comprehensive life-course health strategy targeting the prevention of adversity merits increased attention.
Collapse
Affiliation(s)
- Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Yuwei Yang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Yanyan Ni
- School of Public Health, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China.
| |
Collapse
|
12
|
Bourassa KJ, Moffitt TE, Harrington H, Houts R, Poulton R, Ramrakha S, Rasmussen LJH, Wertz J, Caspi A. Childhood Adversity and Midlife Health: Shining a Light on the Black Box of Psychosocial Mechanisms. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:817-828. [PMID: 36083434 PMCID: PMC9995600 DOI: 10.1007/s11121-022-01431-y] [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] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with poorer health, which has spurred public health efforts to reduce the number of adverse events children experience. Unfortunately, it is unlikely that all ACEs can be prevented. For adults who already experienced ACEs in childhood, what psychological, social, and behavioral intervention targets might reduce risk for negative health outcomes? To provide insight into the "black box" of psychosocial mechanisms linking ACEs to poor health, our study used data from the Dunedin Study, a longitudinal cohort assessed from birth to age 45. Mediation models (N = 859) were used to examine whether candidate psychosocial variables in adulthood explained the association between childhood ACEs and health in midlife. Potential psychosocial mediators included stressful life events, perceived stress, negative emotionality, and health behaviors. Children who experienced more ACEs had poorer health in midlife. They also had significantly more stressful life events, more perceived stress, more negative emotionality, and unhealthier behaviors as adults. These mediators were each independently associated with poorer health in midlife and statistically mediated the association between ACEs and midlife health. Health behaviors evidenced the strongest indirect effect from ACEs to midlife health. Together, these psychosocial mediators accounted for the association between ACEs in childhood and health three decades later. Public health efforts to mitigate the health consequences of ACEs could aim to reduce the stressful life events people experience, reduce negative emotionality, reduce perceived stress, or improve health behaviors among adults who experienced childhood adversity.
Collapse
Affiliation(s)
- Kyle J Bourassa
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
| | - Terrie E Moffitt
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - HonaLee Harrington
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Renate Houts
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Sandhya Ramrakha
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Line J H Rasmussen
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Jasmin Wertz
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- School of Philosophy, Psychology, and Language Science, University of Edinburgh, Edinburgh, Scotland
| | - Avshalom Caspi
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| |
Collapse
|
13
|
Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Thomas EBK, Taylor A, Teague TK, Jenkins NDM. Progressive exercise training improves cardiovascular psychophysiological outcomes in young adult women with a history of adverse childhood experiences. J Appl Physiol (1985) 2023; 134:742-752. [PMID: 36727632 PMCID: PMC10027078 DOI: 10.1152/japplphysiol.00524.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Adverse childhood experiences (ACEs) are early-life psychosocial stressors that are associated with poorer mental health and increased cardiovascular disease (CVD) risk in a dose-dependent manner. We examined the feasibility of an 8-wk combined aerobic and resistance exercise training program to improve systolic (SBP) and diastolic blood pressure (DBP), serum endothelin-1 (ET-1), resilience, hope agency, and hope pathways in young women with ACEs. Forty-two healthy women (21 ± 3 yr) with ≥4 (ACE+; n = 28) or 0 ACEs (ACE-; n = 14) participated in this study. Women with ACEs were randomly assigned to an exercise (ACE+EXT; n = 14) or nonexercise control (ACE+CON; n = 14) group, whereas all ACE- participants were assigned to a nonexercise control (n = 14) group. Hope agency and DBP did not change in any group (P ≥ 0.43), but hope pathways improved only in ACE+EXT (means ± SE change; +1.6 ± 0.74 au, P = 0.032, Hedges' g = 0.53). ET-1 decreased in ACE+EXT only (-0.31 ± 0.15 pg/mL, P = 0.043, g = 0.46). Although the interactions for resilience and SBP did not reach significance (P = 0.05-0.06), forced post hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, P = 0.012, g = 0.64) and SBP tended to improve (-4.0 ± 2.0 mmHg, P = 0.053, g = 0.51) in ACE+EXT only. There were significant associations between changes in hope pathways and SBP (ρ = -0.43, P = 0.023) and ET-1 (ρ = -0.53, P = 0.005), and between changes in SBP and ET-1 (ρ = 0.49; P = 0.012) in the ACE+ group. In summary, structured exercise training reduces serum ET-1 levels, improves positive psychological coping, and may improve SBP in young women with ACEs. The relationships among the changes in hope pathways, SBP, and ET-1 suggest a cardiovascular psychophysiological relationship in young women with ACEs.NEW & NOTEWORTHY This randomized controlled pilot trial shows, for the first time, that 8 wk of structured, progressive exercise training lowers serum endothelin-1 (ET-1) and improves positive psychological coping in young women with significant early-life psychosocial stress. Furthermore, the observed associations among changes in psychological attributes, ET-1, and systolic blood pressure signify a potential interplay between positive psychology and cardiovascular disease risk among women with adverse childhood experiences.
Collapse
Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio, United States
| | | | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, Oklahoma, United States
| | - Emily B K Thomas
- Department of Psychology and Brain Sciences, University of Iowa, Iowa City, Iowa, United States
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Science, Tulsa, Oklahoma, United States
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
| |
Collapse
|
14
|
Adebiyi E, Pietri-Toro J, Awujoola A, Gwynn L. Association of Adverse Childhood Experiences with Heart Conditions in Children: Insight from the 2019-2020 National Survey of Children's Health. CHILDREN (BASEL, SWITZERLAND) 2023; 10:486. [PMID: 36980044 PMCID: PMC10047196 DOI: 10.3390/children10030486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023]
Abstract
Adverse Childhood Experiences (ACEs) have been associated with a higher risk of developing cardiovascular diseases and premature mortality in adults. OBJECTIVES We evaluated the associations between ACEs and heart diseases among children in the United States. METHODS Data on children ages 0 to 17 years reported by parents/guardians to have current heart conditions were analyzed. Using Stata version 17 software, descriptive statistics were generated for the demographic characteristics and the various health outcomes using the chi-square of independence. Multivariate logistic regression models were employed to determine the associations between ACEs and heart conditions, the severity of heart conditions, and overall health status. RESULTS There were 826 children with current heart conditions from a total of 68,753 surveyed children. This corresponded to an estimated 780,000 (1.13%) children living with heart conditions in the U.S. On multivariate logistic models, several ACEs, including household economic hardship, parental/guardian's alcohol/drug abuse, severe mental health illness of parents/guardians, racial/ethnic discrimination, exposure to neighborhood violence, and accumulation of two or more ACEs, were significantly associated with heart diseases among children. Though the accumulation of two or more ACEs did not have a significant association with the severity of heart condition, it was significantly associated with caregiver reports of undesirable overall health status. CONCLUSIONS ACEs are significantly associated with heart conditions among children and contribute to unfavorable overall health status among children with heart conditions in the U.S. There is a need for policies and programs that will promptly identify ACEs and mitigate their negative impact on children.
Collapse
Affiliation(s)
- Ebenezer Adebiyi
- Department of Pediatrics, University of Miami/Jackson Health System, Miami, FL 33136, USA
| | - Jariselle Pietri-Toro
- Department of Pediatrics, University of Miami/Jackson Health System, Miami, FL 33136, USA
| | - Adeola Awujoola
- Department of Pediatrics, BronxCare Health System, New York, NY 10457, USA
| | - Lisa Gwynn
- Department of Pediatrics, University of Miami/Jackson Health System, Miami, FL 33136, USA
| |
Collapse
|
15
|
Li Piani L, Vigano' P, Somigliana E. Epigenetic clocks and female fertility timeline: A new approach to an old issue? Front Cell Dev Biol 2023; 11:1121231. [PMID: 37025178 PMCID: PMC10070683 DOI: 10.3389/fcell.2023.1121231] [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: 12/11/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Worldwide increase in life expectancy has boosted research on aging. Overcoming the concept of chronological age, higher attention has been addressed to biological age, which reflects a person's real health state, and which may be the resulting combination of both intrinsic and environmental factors. As epigenetics may exert a pivotal role in the biological aging, epigenetic clocks were developed. They are based on mathematical models aimed at identifying DNA methylation patterns that can define the biological age and that can be adopted for different clinical scopes (i.e., estimation of the risks of developing age-related disorders or predicting lifespan). Recently, epigenetic clocks have gained a peculiar attention in the fertility research field, in particular in the female counterpart. The insight into the possible relations between epigenetic aging and women's infertility might glean additional information about certain conditions that are still not completely understood. Moreover, they could disclose significant implications for health promotion programs in infertile women. Of relevance here is that the impact of biological age and epigenetics may not be limited to fertility status but could translate into pregnancy issues. Indeed, epigenetic alterations of the mother may transfer into the offspring, and pregnancy itself as well as related complications could contribute to epigenetic modifications in both the mother and newborn. However, even if the growing interest has culminated in the conspicuous production of studies on these topics, a global overview and the availability of validated instruments for diagnosis is still missing. The present narrative review aims to explore the possible bonds between epigenetic aging and fertility timeline. In the "infertility" section, we will discuss the advances on epigenetic clocks focusing on the different tissues examined (endometrium, peripheral blood, ovaries). In the "pregnancy" section, we will discuss the results obtained from placenta, umbilical cord and peripheral blood. The possible role of epigenetic aging on infertility mechanisms and pregnancy outcomes represents a question that may configure epigenetic clock as a bond between two apparently opposite worlds: infertility and pregnancy.
Collapse
Affiliation(s)
- Letizia Li Piani
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
- *Correspondence: Letizia Li Piani,
| | - Paola Vigano'
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
16
|
Liu Y, Wang C, Liu Y. Association between adverse childhood experiences and later-life cardiovascular diseases among middle-aged and older Chinese adults: The mediation effect of depressive symptoms. J Affect Disord 2022; 319:277-285. [PMID: 36162657 DOI: 10.1016/j.jad.2022.09.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/27/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND To date, few studies have focused on examining either the direct or indirect effect of adverse childhood experiences (ACEs) on cardiovascular diseases (CVD). This study aimed to investigate the mediation effect of depressive symptoms as a mediator between ACEs and CVD. METHODS This study included a total of 12,981 participants from the 2011 to 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were examined using the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CESD-10). The mediation effect analysis adjusted for potential confounding factors was conducted. RESULTS 6635 (51.11 %) of the participants reported 4 and more ACEs count. Participants with certain ACEs were significantly associated with later-life incident depressive symptoms and CVD. Depressive symptoms partially mediated [20.72 %, 95 % CI: (13.02 %-38.12 %)] of the association between self-reported health status and CVD, [0.72 %, 95 % CI: (13.02 %-38.12 %)] of the association between health limitation and CVD, and [22.24 %, 95 % CI: (14.35 %-59.29 %)] of the association between hunger and CVD. In addition, as ACEs count increased by 1 unit, participants had the increased risk of incident depressive symptoms [5.01 %, 95 % CI: (4.53 %-5.50 %)] and CVD [0.61 %, 95 % CI: (0.23 %-0.99 %)]. LIMITATIONS Not all potential confounding factors were measured and adjusted in the analysis, and ACEs were collected retrospectively. CONCLUSIONS ACEs are significantly associated with both onset and increased depressive symptoms and CVD, and depressive symptoms mediated the association between ACEs and incident CVD. Our results suggested that target mental health intervention programs should be delivered to ACEs populations.
Collapse
Affiliation(s)
- Yunguang Liu
- Department of Public Health, Medical College of Qinghai University, Xining 810001, Qinghai, China
| | - Chaocai Wang
- Department of Infection Disease, Qinghai Center for Disease Prevention and Control, Xining 810001, Qinghai, China
| | - Yan Liu
- Department of Public Health, Medical College of Qinghai University, Xining 810001, Qinghai, China.
| |
Collapse
|
17
|
Rampersaud R, Protsenko E, Yang R, Reus V, Hammamieh R, Wu GWY, Epel E, Jett M, Gautam A, Mellon SH, Wolkowitz OM. Dimensions of childhood adversity differentially affect biological aging in major depression. Transl Psychiatry 2022; 12:431. [PMID: 36195591 PMCID: PMC9532396 DOI: 10.1038/s41398-022-02198-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 09/11/2022] [Accepted: 09/21/2022] [Indexed: 11/08/2022] Open
Abstract
Adverse childhood experiences have been consistently linked with physical and mental health disorders in adulthood that may be mediated, in part, via the effects of such exposures on biological aging. Using recently developed "epigenetic clocks", which provide an estimate of biological age, several studies have demonstrated a link between the cumulative exposure to childhood adversities and accelerated epigenetic aging. However, not all childhood adversities are equivalent and less is known about how distinct dimensions of childhood adversity relate to epigenetic aging metrics. Using two measures of childhood adversity exposure, we assess how the dimensions of Maltreatment and Household Dysfunction relate to epigenetic aging using two "second-generation" clocks, GrimAge and PhenoAge, in a cohort of unmedicated somatically healthy adults with moderate to severe major depression (n = 82). Our results demonstrate that the dimension of Maltreatment is associated with epigenetic age acceleration (EAA) using the PhenoAge but not the GrimAge clock. This association was observed using both the Childhood Trauma questionnaire (CTQ; β = 0.272, p = 0.013) and the Adverse Childhood Experiences (ACEs) questionnaire (β = 0.307, p = 0.005) and remained significant when adjusting for exposure to the dimension of Household Dysfunction (β = 0.322, p = 0.009). In contrast, the dimension of Household Dysfunction is associated with epigenetic age deceleration (β = -0.194, p = 0.083) which achieved significance after adjusting for exposure to the dimension of Maltreatment (β = -0.304, p = 0.022). This study is the first to investigate these effects among individuals with Major Depressive Disorder and suggests that these dimensions of adversity may be associated with disease via distinct biological mechanisms.
Collapse
Affiliation(s)
- Ryan Rampersaud
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA.
| | - Ekaterina Protsenko
- University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Ruoting Yang
- Medical Readiness Systems Biology, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Victor Reus
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Rasha Hammamieh
- Medical Readiness Systems Biology, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Gwyneth W Y Wu
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elissa Epel
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Marti Jett
- Headquarters, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Aarti Gautam
- Medical Readiness Systems Biology, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Synthia H Mellon
- Department of OB-GYN and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Owen M Wolkowitz
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| |
Collapse
|
18
|
León I, Herrero Roldán S, Rodrigo MJ, López Rodríguez M, Fisher J, Mitchell C, Lage-Castellanos A. The shared mother-child epigenetic signature of neglect is related to maternal adverse events. Front Physiol 2022; 13:966740. [PMID: 36091392 PMCID: PMC9448913 DOI: 10.3389/fphys.2022.966740] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Studies of DNA methylation have revealed the biological mechanisms by which life adversity confers risk for later physical and mental health problems. What remains unknown is the “biologically embedding” of maternal adverse experiences resulting in maladaptive parenting and whether these epigenetic effects are transmitted to the next generation. This study focuses on neglectful mothering indexed by a severe disregard for the basic and psychological needs of the child. Using the Illumina Human Methylation EPIC BeadChip in saliva samples, we identified genes with differentially methylated regions (DMRs) in those mothers with (n = 51), versus those without (n = 87), neglectful behavior that present similar DMRs patterns in their children being neglected versus non-neglected (n = 40 vs. 75). Mothers reported the emotional intensity of adverse life events. After covariate adjustment and multiple testing corrections, we identified 69 DMRs in the mother epigenome and 42 DMRs in the child epigenome that were simultaneously above the α = 0.01 threshold. The common set of nine DMRs contained genes related to childhood adversity, neonatal and infant diabetes, child neurobehavioral development and other health problems such as obesity, hypertension, cancer, posttraumatic stress, and the Alzheimer’s disease; four of the genes were associated with maternal life adversity. Identifying a shared epigenetic signature of neglect linked to maternal life adversity is an essential step in breaking the intergenerational transmission of one of the most common forms of childhood maltreatment.
Collapse
Affiliation(s)
- Inmaculada León
- Instituto Universitario de Neurociencia, Universidad de La Laguna, San Cristóbal de la Laguna, Spain
- Facultad de Psicología, Universidad de La Laguna, San Cristóbal de la Laguna, Spain
| | - Silvia Herrero Roldán
- Instituto Universitario de Neurociencia, Universidad de La Laguna, San Cristóbal de la Laguna, Spain
- Facultad de Psicología, Universidad de La Laguna, San Cristóbal de la Laguna, Spain
- *Correspondence: Silvia Herrero Roldán,
| | - María José Rodrigo
- Instituto Universitario de Neurociencia, Universidad de La Laguna, San Cristóbal de la Laguna, Spain
- Facultad de Psicología, Universidad de La Laguna, San Cristóbal de la Laguna, Spain
| | - Maykel López Rodríguez
- Department of Pathology and Experimental Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Jonah Fisher
- Institute for Social Research, University of Michigan, Ann Abor, MI, United States
| | - Colter Mitchell
- Institute for Social Research, University of Michigan, Ann Abor, MI, United States
| | - Agustín Lage-Castellanos
- Department of NeuroInformatics, Cuban Center for Neuroscience, Havana, Cuba
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
19
|
Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences. Microorganisms 2022; 10:microorganisms10020229. [PMID: 35208684 PMCID: PMC8879770 DOI: 10.3390/microorganisms10020229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.
Collapse
|
20
|
Mei X, Mei R, Liu Y, Wang X, Chen Q, Lei Y, Ye Z. Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model. Front Psychiatry 2022; 13:1091042. [PMID: 36590638 PMCID: PMC9797834 DOI: 10.3389/fpsyt.2022.1091042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress. METHODS A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed. RESULTS In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (β = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (β = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant. CONCLUSION Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.
Collapse
Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ranran Mei
- Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuling Liu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qianwen Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Youjin Lei
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
21
|
Li S, Wang R, Thomas E, Jiang Z, Jin Z, Li R, Qian Y, Song X, Sun Y, Zhang S, Chen R, Wan Y. Patterns of adverse childhood experiences and depressive symptom trajectories in young adults: A longitudinal study of college students in China. Front Psychiatry 2022; 13:918092. [PMID: 35958653 PMCID: PMC9358020 DOI: 10.3389/fpsyt.2022.918092] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) tend to cluster together in daily life, and most studies focus on the level of depression at certain points, but the dynamic process of depression is often neglected. Thus, research is urgently needed to explore the relationship between ACEs pattern and trajectory of depressive symptom levels at multiple time points in order to provides early targeted interventions to those who are most at risk. OBJECTIVE We aimed to explore patterns of ACEs, including types and timing, associated with depression trajectories in college students. METHODS A school-based health survey was used to collect data as part of a longitudinal study in two medical college in Anhui province, China. Questionnaires were issued to 3,662 participants aged 17-22 and recorded details of ACEs (types and timing) and depression. Latent class analysis (LCA) was used to identify "patterns" of ACEs type and timing. Depressive symptom trajectories employed latent class growth analysis (LCGA). Multiple logistic regressions were employed to evaluate the relationships between ACEs patterns and depressive symptom trajectories. RESULTS We identified five ACEs patterns: "High neglect/emotional abuse/community violence," "High neglect/emotional abuse," "High neglect/family dysfunction," "High neglect," "Low ACEs." We traced three depression trajectories: "High depressive symptom" "Moderate depressive symptom," "Low depressive symptom." "High neglect/emotional abuse/community violence," "High neglect/emotional abuse" and "High neglect/family dysfunction" demonstrated a high risk for "High depressive symptom" and "Moderate depressive symptom." "High neglect" showed a high risk for "Moderate depressive symptom" but not for "High depressive symptom" (P < 0.05). CONCLUSIONS The findings address the need for a comprehensive consideration of exposure to childhood adversity associated with the risk of depression in young adults through identifying more problematic ACEs patterns amongst exposed children.
Collapse
Affiliation(s)
- Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Rui Wang
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Erica Thomas
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Yan Qian
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Xianbing Song
- Department of Human Anatomy, Histology and Embryology, Anhui Medical College, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| |
Collapse
|
22
|
Nwanaji-Enwerem JC, Van Der Laan L, Kogut K, Eskenazi B, Holland N, Deardorff J, Cardenas A. Maternal adverse childhood experiences before pregnancy are associated with epigenetic aging changes in their children. Aging (Albany NY) 2021; 13:25653-25669. [PMID: 34923483 PMCID: PMC8751604 DOI: 10.18632/aging.203776] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023]
Abstract
Emerging research suggests associations of physical and psychosocial stressors with epigenetic aging. Although this work has included early-life exposures, data on maternal exposures and epigenetic aging of their children remain sparse. Using longitudinally collected data from the California, Salinas Valley CHAMACOS study, we examined relationships between maternal Adverse Childhood Experiences (ACEs) reported up to 18 years of life, prior to pregnancy, with eight measures (Horvath, Hannum, SkinBloodClock, Intrinsic, Extrinsic, PhenoAge, GrimAge, and DNAm telomere length) of blood leukocyte epigenetic age acceleration (EAA) in their children at ages 7, 9, and 14 years (N = 238 participants with 483 observations). After adjusting for maternal chronological age at delivery, pregnancy smoking/alcohol use, parity, child gestational age, and estimated leukocyte proportions, higher maternal ACEs were significantly associated with at least a 0.76-year increase in child Horvath and Intrinsic EAA. Higher maternal ACEs were also associated with a 0.04 kb greater DNAm estimate of telomere length of children. Overall, our data suggests that maternal preconception ACEs are associated with biological aging in their offspring in childhood and that preconception ACEs have differential relationships with EAA measures, suggesting different physiologic utilities of EEA measures. Studies are necessary to confirm these findings and to elucidate potential pathways to explain these relationships, which may include intergenerational epigenetic inheritance and persistent physical and social exposomes.
Collapse
Affiliation(s)
- Jamaji C Nwanaji-Enwerem
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, GA 30322, USA.,Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.,Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Lars Van Der Laan
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Katherine Kogut
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Brenda Eskenazi
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA.,Community Health Sciences Division, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Nina Holland
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Julianna Deardorff
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA.,Community Health Sciences Division, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA
| |
Collapse
|
23
|
Deschênes SS, Kivimaki M, Schmitz N. Adverse Childhood Experiences and the Risk of Coronary Heart Disease in Adulthood: Examining Potential Psychological, Biological, and Behavioral Mediators in the Whitehall II Cohort Study. J Am Heart Assoc 2021; 10:e019013. [PMID: 33938232 PMCID: PMC8200717 DOI: 10.1161/jaha.120.019013] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background This study investigated potential psycho‐bio‐behavioral mediators of the association between adverse childhood experiences (ACEs) and the risk of coronary heart disease (CHD) in adulthood. Methods and Results Participants were 5610 British civil servants (mean age, 55.5; 28% women) from the Whitehall II cohort study without CHD at baseline in 1997 to 1999 (wave 5) when retrospective data on the number of ACEs were collected via questionnaire (range, 0–8). Potential mediators assessed at wave 5 included depression and anxiety symptoms, health behaviors (smoking, alcohol dependence, sleep, and physical activity), and cardiometabolic dysregulations. New diagnoses of CHD (myocardial infarction, definite angina, coronary artery bypass grafting, or percutaneous transluminal coronary angioplasty) were assessed from wave 6 (2001) to wave 11 (2012–2013). Logistic regressions examined associations between ACEs, potential mediators, and CHD during the follow‐up period. Natural indirect effects were examined using mediation analysis. A total of 566 (10.1%) participants developed CHD during the follow‐up period. ACEs were associated with an increased likelihood of CHD (odds ratio per ACE, 1.09; 95% CI, 1.00–1.19). Controlling for age and sex, mediation analyses revealed an indirect effect of depression symptoms (natural indirect effects, 1.05; 95% CI, 1.03–1.07), anxiety symptoms (natural indirect effects, 1.12; 95% CI, 1.10–1.15), and a greater number of cardiometabolic dysregulations (natural indirect effects, 1.02; 95% CI, 1.01–1.03) in the association between ACEs and incident CHD. Behavioral factors were not statistically significant mediators. Conclusions Depression symptoms, anxiety symptoms, and cardiometabolic dysregulations partially mediated the association between ACEs and CHD. Regular screening and treatment of symptoms of psychological disorders and cardiometabolic dysregulations may help mitigate the long‐term health burden of ACEs.
Collapse
Affiliation(s)
| | - Mika Kivimaki
- Department of Epidemiology and Public Health University College London London United Kingdom
| | - Norbert Schmitz
- Department of Psychiatry McGill University Montreal Canada.,Douglas Mental Health University Institute Montreal Canada.,Department of Population-Based Medicine Medical University Hospital TübingenUniversity of Tübingen Tübingen Germany
| |
Collapse
|
24
|
Kudesia P, Salimarouny B, Stanley M, Fortin M, Stewart M, Terry A, Ryan BL. The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2021; 11:26335565211032880. [PMID: 34350127 PMCID: PMC8287424 DOI: 10.1177/26335565211032880] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022]
Abstract
Multimorbidity, the presence of 1+ chronic condition in an individual, remains one of the greatest challenges to health on a global scale. Although the prevalence of multimorbidity has been well-established, its incidence is not fully understood. This systematic review determined the incidence of multimorbidity across the lifespan; the order in which chronic conditions accumulate to result in multimorbidity; and cataloged methods used to determine and report accumulation of chronic conditions resulting in multimorbidity. Studies were identified by searching MEDLINE, Embase, CINAHL, and Cochrane electronic databases. Two independent reviewers evaluated studies for inclusion and performed quality assessments. Of 36 included studies, there was high heterogeneity in study design and operational definitions of multimorbidity. Studies reporting incidence (n = 32) reported a median incidence rate of 30.7 per 1,000 person-years (IQR 39.5 per 1,000 person-years) and a median cumulative incidence of 2.8% (IQR 28.7%). Incidence was notably higher for persons with older age and 1+ chronic conditions at baseline. Studies reporting patterns in accumulation of chronic conditions (n = 5) reported hypertensive and heart diseases, and diabetes, as among the common starting conditions resulting in later multimorbidity. Methods used to discern patterns were highly heterogenous, ranging from the use of latent growth trajectories to divisive cluster analyses, and presentation using alluvial plots to cluster trajectories. Studies reporting the incidence of multimorbidity and patterns in accumulation of chronic conditions vary greatly in study designs and definitions used. To allow for more accurate estimations and comparison, studies must be transparent and consistent in operational definitions of multimorbidity applied.
Collapse
Affiliation(s)
- Prtha Kudesia
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Banafsheh Salimarouny
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Meagan Stanley
- Allyn & Betty Taylor Library, University of Western
Ontario, London, Ontario, Canada
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Moira Stewart
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Amanda Terry
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Bridget L Ryan
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| |
Collapse
|