Background Childhood maltreatment (neglect and abuse) has been associated with cardiometabolic disease in adults, but evidence is sparse. Using a population cohort we aimed to investigate whether different forms of child maltreatment were associated with cardiometabolic biomarkers in mid-life and potential explanations for the associations.
Methods The 1958 British birth cohort includes all born in one week in 1958, followed to mid-adulthood. Information was collected on childhood neglect and abuse (physical, sexual, psychological) and adult (45 y) cardiometabolic markers (blood pressure, lipids, glycated haemoglobin (HbA1c) (n ~ 9000). The associations between child maltreatment and cardiometabolic markers were tested using linear regression or logistic regression, as appropriate, adjusting for (1) early life covariates and (2) child-to-adult BMI, adult social position, lifestyles and mental health.
Results Approximately 17.4% of participants were identified as neglected (≥2 neglect indicators at ages 7 and/or 11 y) and 12% reported childhood abuse; prevalence varied from sexual (1.6%), physical (6%) to psychological abuse (10%). Childhood neglect was associated with raised triglycerides by 3.9% (95% CI: 0.4%, 7.4%) and HbA1c by 1.2% (0.4%, 2.0%), and for females only, lower HDL-c by 0.05 (0.01, 0.08) mmol/L after adjusting for early life covariates. Physical abuse was associated with increased risk of high LDL-c (OR = 1.24 (1.00, 1.55)), and in males, raised HbA1c by 2.4% (0.6%, 4.2%) and in females, lower HDL-c by 0.06 (0.01, 0.12) mmol/L. The magnitude of associations for sexual abuse were comparable to those of physical abuse but CIs were wide due to few cases (e.g. OR = 1.42 (0.89, 2.24) for high LDL-c). Psychological abuse was associated with increased risk of high triglycerides (OR = 1.23 (1.03, 1.46)) and low HDL-c by 0.04 (0.01, 0.07) mmol/L. All associations disappeared after further adjustment: adult lifestyle was a key explanatory factor for most associations, whilst adult social position was important for neglect but not abuse, child-to-adult BMI was important for associations with neglect and physical abuse, and mental health was important for psychological abuse. Maltreatments were not associated with raised blood pressure.
Conclusion Childhood maltreatments were associated with poorer lipid and HbA1c profiles in mid-adulthood, suggesting that there may be further long-term health consequences. All associations disappeared when adjusted for potential explanatory factors, in particular for adult lifestyles. Lifetime BMI trajectory was also implicated as an explanation for physical abuse, socio-economic position for neglect and mental health for childhood psychological abuse.