Early Life Stress and Cardiometabolic Risks: Systematic Review and Meta-analysis

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Health, Growth, Injury

Abstract

Objectives: Early life stress (ELS), which includes physical, sexual, and emotional forms of abuse, neglect, and deprivation experienced by the developing child, has been linked to suboptimal health outcomes (Centers for Disease Control and Prevention, 2018; Fogelman & Canli, 2019). Particularly, increasing evidence has shown that such adverse experience could be an independent predictor of the development of cardiometabolic diseases (Loria, Ho & Pollock, 2013; Galobardes, Smith & Lynch, 2006). However, there have been mixed results on whether the effect of ELS on the cardiometabolic system would emerge before adulthood, especially during the first decade of life when child development is most sensitive to the environment. Additionally, more evidence is needed to illustrate the ELS-cardiometabolic risk association in adulthood, such that the long-term impact of ELS on the human cardiometabolic system can be better characterized. Broadly, our first goal is to examine comprehensively the direction and the magnitude of the ELS-cardiometabolic risk association. To explain the heterogenous results across previous findings, our second aim is to examine the potential moderators (e.g., age of participants when ELS occurs) in the ELS-cardiometabolic risk relationship.

Methods and Analysis Plan: In this meta-analysis, we will include original, peer-reviewed full articles, in which the definition of ELS should be consistent with one of the following: physical, sexual and emotional abuse, poverty, institutional care, community/neighborhood violence, and food insecurity. The definition of cardiometabolic risk should include elevated risks in the human autonomic nervous system, anthropometrics, the metabolic system, the immune system, or the vasculature. Search: The search has been performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Information including search databases, the inclusion and exclusion criteria can be found in Table 1. Data synthesis: The meta-analysis will be carried out using a random-effects model, which includes both sampling and study-level errors. Hypotheses: I. There would be a significant main effect of ELS on human cardiometabolic risk, such that ELS would be associated with elevated cardiometabolic risk. To examine that, we will extract adjusted effect sizes to measure the effects of ELS independent of the influence of potential covarying variables. Extracted data will be converted to odds ratios to reflect the likelihood of cardiometabolic risk in individuals exposed to ELS. II. The heterogeneous results across previous studies may be explained by the age of participants when stressful events occur. Specifically, younger age with ELS exposure would be associated with a higher cardiometabolic risk than older age. This hypothesis will be examined by a meta-regression analysis.

Implications: The study would contribute to a comprehensive understanding of ELS’ short- and long-term impacts on human cardio-and metabolic systems. In practice, the present study would help inform clinicians of the effect of ELS on people’s health, such that timely prevention and intervention can be designed and implemented.

Feasibility: As shown in Figure 1, primary identification and screening have been completed (Cohen’s Kappa=0.9). Data extraction and synthesis will be finished by December 2020. Therefore, we expect no problem completing and presenting this project by April 2021.

Authors

• Danruo Zhong, University of Minnesota - Twin Cities
  Presenting Author

• Qiyue Cai, University of Minnesota - Twin Cities
  Non-Presenting Author

• Amy Riegelman, University of Minnesota
  Non-Presenting Author