Early life adversity and physical health implications in adulthood: The Multi-Ethnic Study of Atherosclerosis.

introductionSeveral biological processes have been implicated in explaining the association between exposure to early life adversity (ELA) and poor health outcomes later in life, but most studies have classified ELA in terms of a simple count of adverse childhood events (ACEs). Few studies have also considered how race/ethnicity might modify these associations.

objectivesTo determine to what extent different dimensions of ELA (threat and deprivation) influence cardiometabolic and inflammatory dysregulation in adulthood by race/ethnic groups.

methodsParticipants in MESA, ages 45-84, were recruited from 2000 to 2002. Information regarding ELA was collected at the 2020 follow up call. Measures of inflammation (C-Reactive Protein, CRP) and cardiometabolic dysfunction (index of risk and prevalence of metabolic syndrome) were assessed at the MESA baseline exam (mid- to later life for participants); cardiovascular disease events were ascertained throughout the 20 year follow-up period. Logistic and linear regression models were fit for the relevant outcomes and adjusted for age, sex, nativity, MESA site, parental education, education, income, levels of optimism and pessimism.

resultsThese findings suggest some modest associations between reported experiences of ELA related to threat and deprivation and elevated CRP, metabolic dysfunction and increased risk of CVD, however these associations varied by type of ELA and by race/ethnic groups. Unexpectedly, we also found some indirect associations between reported types of ELA and lower risk of those same health outcomes.

conclusionsThe inconsistent trends across race/ethnic groups, ELA dimensions and health outcomes highlight the need for a dimensional approach in classifying experiences of ELA, and suggest potential cultural differences in reporting ELA in adulthood.