ESPE Yearbook of Paediatric Endocrinology

Journal of the American Heart Association 2021;10(24):e021701. doi: 10.1161/JAHA.121.021701

Brief Summary: This population-based birth cohort study identified an association between childhood abuse and higher BMI at age 18 and 25 years, and also hyperinsulinemia and other markers of the MetS at age 25.

Comment: Previous studies reported that about one-third of adult candidates for bariatric surgery with extreme obesity had undergone sexual abuse. A relation between early life abuse and gestational diabetes has also been reported. Further, an increased risk of T2DM was described among middle-aged women according to the degree of physical and sexual abuse in childhood and adolescence. Additionally, several studies have reported associations of childhood abuse with increased risks of parameters of the MetS in adulthood. However, this subject is so important that it deserves repeated discussion and increased awareness.

This study is part of a population-based birth cohort. A questionnaire that included the three types of abuse (i.e. physical, sexual and psychological) was completed by 3921 individuals. Physical abuse was reported by 5.0%, mostly before age 11 years, sexual abuse by 12.0% of females and 3.4% of males, and psychological abuse by 13.7% of females and 10.2% of males. Different types of abuse commonly co-occurred. All three types of abuse were associated with higher BMI at age 18 years, and increased frequency of abuse occurrence was associated with higher BMI. At age 25 years, all types of abuse were also associated with higher insulin levels. The age when the abuse occurred was not associated with cardiometabolic outcomes.

Possible explanations for the association between childhood abuse and cardiometabolic health include emotional eating, obesity and direct physiological changes resulting from the stress response system. The key message from this article to pediatricians is the importance of awareness of the possibility of any type of abuse among children with obesity.