title: Relationship between abuse and neglect in childhood and diabetes in adulthood: differential effects by sex, national longitudinal study of adolescent health.
abstract: BACKGROUND
  Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults.
  
  
  METHODS
  We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate.
  
  
  RESULTS
  Although the prevalence of diabetes was similar for men and women (7.0% vs 6.7%), men were more likely than women to have prediabetes (36.3% vs 24.6%; omnibus P < .001). Among men, recurrent sexual abuse (≥3 lifetime incidents) was significantly associated with diabetes (OR, 3.66; 95% CI, 1.31-10.24), but not with prediabetes. There was no evidence of mediation by BMI. No forms of child abuse or neglect were associated with diabetes or prediabetes among women.
  
  
  CONCLUSIONS
  Recurrent sexual abuse is robustly associated with diabetes in young adult men, independently of other forms of child abuse or neglect and BMI. Future research should explore other potential mechanisms for this association to identify avenues for prevention of diabetes among men who have experienced sexual abuse.
authors.affiliation: George Warren Brown School of Social Work, Washington University, One Brookings Dr, Campus Box 1196, St Louis, MO 63130. Email: aduncan@wustl.edu. Dr Duncan is also affiliated with the Center for Diabetes Translational Research of Washington University and the Midwest Alcoholism Research Center and the Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Duncan
authors.affiliation: Washington University and Washington University School of Medicine, St Louis, Missouri.
authors.forename: Wendy F
authors.initials: WF
authors.lastname: Auslander
authors.affiliation: Washington University and Washington University School of Medicine, St Louis, Missouri.
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Bucholz
authors.affiliation: Washington University, St Louis, Missouri.
authors.forename: Darrell L
authors.initials: DL
authors.lastname: Hudson
authors.affiliation: Washington University and Washington University School of Medicine, St Louis, Missouri.
authors.forename: Richard I
authors.initials: RI
authors.lastname: Stein
authors.affiliation: Washington University and Washington University School of Medicine, St Louis, Missouri.
authors.forename: Neil H
authors.initials: NH
authors.lastname: White
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D015992:Body Mass Index; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D011236:Prediabetic State / Q000453:epidemiology; D012008:Recurrence; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult