Association of adverse childhood experiences with lipid profiles and atherogenic risk indices in a middle-to-older aged population

Emily O'Leary; Seán R Millar; Ivan J Perry; Catherine M Phillips

doi:10.1016/j.ssmph.2023.101393

Association of adverse childhood experiences with lipid profiles and atherogenic risk indices in a middle-to-older aged population

SSM Popul Health. 2023 Apr 5:22:101393. doi: 10.1016/j.ssmph.2023.101393. eCollection 2023 Jun.

Authors

Emily O'Leary¹, Seán R Millar², Ivan J Perry², Catherine M Phillips¹

Affiliations

¹ School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
² School of Public Health, University College Cork, Cork, Ireland.

Abstract

Background: Adverse childhood experiences (ACE) have been associated with poor later life health outcomes, including cardiovascular disease (CVD). Limited research investigating potential underlying biological mechanisms linking ACE to CVD exists, particularly regarding lipid biomarkers.

Objectives: The aim of this study was to examine the associations between childhood adversity and unfavourable lipid profiles and derived atherogenic risk indices in a middle-to-older aged population.

Methods: This cross-sectional study includes 1820 participants from the Mitchelstown cohort (49% male) in Ireland. Participants' self-reported history of childhood adversity (overall and by subtypes household dysfunction, abuse and neglect) were assessed through a validated 10-item ACE questionnaire. Lipid profiles were determined and atherogenic risk indices including Castelli's Risk Index 1 and 2 (CRI-I and CRI-II), Atherogenic Coefficient (AC) and Atherogenic Index Plasma (AIP) were generated. Logistic regression analysed ACE associations with unfavourable lipid outcomes, controlling for potential confounders.

Results: ACE history (reported by 23% of sample), in particular childhood exposure to household dysfunction, was associated with later-life non-optimal TG and HDL-C concentrations and atherogenic risk indices CRI-II and AC in age and sex-adjusted models (all p < 0.05). In fully adjusted models, adults reporting ACE or exposure to household dysfunction were approximately twice as likely to have pro-atherogenic CRI-II relative to adults with no ACE (OR = 1.86, 95% CI: 1.19-2.92, p = 0.006 and OR = 2.19, 95% CI: 1.33-3.61, p = 0.002, respectively). Sex-stratified analysis demonstrated sex-specific associations.

Conclusions: This study provides evidence that ACEs are common among older adults in Ireland and are associated with unfavourable lipid profiles and derived atherogenic risk indices.

Keywords: Adverse childhood experiences; Atherogenic risk indices; Cardiovascular disease; Cholesterol; Lipid biomarkers.