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Increased Cardiometabolic Risk in Healthy Young Adults With Early Life Stress
Meghan J Kulak1, William Lewis-de Los Angeles, Teresa E Daniels
1From the Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior (Kulak, Daniels, Mathis, Gobin, Laumann, Beck, Tyrka), Warren Alpert Medical School, Brown University; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience (Kulak, Daniels, Gobin, Laumann, Beck, Tyrka), Butler Hospital; Department of Pediatrics (Lewis-de los Angeles), Hasbro Children's Hospital and Bradley Hospital; Warren Alpert Medical School (Lewis-de los Angeles), Brown University, Providence; University of Rhode Island College of Nursing (Mathis), Kingston, Rhode Island.
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.
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