title: Accumulation of Major Life Events in Childhood and Adult Life and Risk of Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  The aim of the study was to estimate the effect of the accumulation of major life events (MLE) in childhood and adulthood, in both the private and working domains, on risk of type 2 diabetes mellitus (T2DM). Furthermore, we aimed to test the possible interaction between childhood and adult MLE and to investigate modification of these associations by educational attainment.
  
  
  METHODS
  The study was based on 4,761 participants from the Copenhagen City Heart Study free of diabetes at baseline and followed for 10 years. MLE were categorized as 0, 1, 2, 3 or more events. Multivariate logistic regression models adjusted for age, sex, education and family history of diabetes were used to estimate the association between MLE and T2DM.
  
  
  RESULTS
  In childhood, experiencing 3 or more MLE was associated with a 69% higher risk of developing T2DM (Odds Ratio (OR) 1.69; 95% Confidence Interval (CI) 1.60, 3.27). The accumulation of MLE in adult private (p-trend = 0.016) and work life (p-trend = 0.049) was associated with risk of T2DM in a dose response manner. There was no evidence that experiencing MLE in both childhood and adult life was more strongly associated with T2DM than experiencing events at only one time point. There was some evidence that being simultaneously exposed to childhood MLE and short education (OR 2.28; 95% C.I. 1.45, 3.59) and work MLE and short education (OR 2.86; 95% C.I. 1.62, 5.03) was associated with higher risk of T2DM, as the joint effects were greater than the sum of their individual effects.
  
  
  CONCLUSIONS
  Findings from this study suggest that the accumulation of MLE in childhood, private adult life and work life, respectively, are risk factors for developing T2DM.
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Health Aging, University of Copenhagen, Copenhagen, Denmark; Copenhagen Stress Research Center, Copenhagen, Denmark.
authors.forename: Jolene
authors.initials: J
authors.lastname: Masters Pedersen
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark; Copenhagen Stress Research Center, Copenhagen, Denmark.
authors.forename: Naja
authors.initials: N
authors.lastname: Hulvej Rod
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ingelise
authors.initials: I
authors.lastname: Andersen
authors.affiliation: Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Theis
authors.initials: T
authors.lastname: Lange
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gry
authors.initials: G
authors.lastname: Poulsen
authors.affiliation: Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Health Aging, University of Copenhagen, Copenhagen, Denmark; Copenhagen Stress Research Center, Copenhagen, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Lund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult