title: Metabolic pathways link childhood adversity to elevated blood pressure in midlife adults.
abstract: Childhood adversity is a risk factor for adult health outcomes, including obesity and hypertension. This study examines whether childhood adversity predicted mean arterial pressure through mechanisms of central obesity and leptin, adiponectin, and/or insulin resistance, and including dietary quality. 210 Black/African Americans and White/European Americans, mean age=45.8; ±3.3 years, were studied cross-sectionally. Path analyses were used to specify a chain of predictive variables in which childhood adversity predicted waist-hip ratio and dietary quality, circulating levels of hormones, and in turn, mean arterial pressure, adjusting for race, gender, and antihypertensive medications. Direct paths were found between childhood adversity, waist-hip ratio, and leptin levels and between leptin and dietary quality to mean arterial pressure. Systolic and diastolic blood pressures were similarly predicted. Early adversity appears to developmentally overload and dysregulate endocrine systems through increased risk for obesity, and through a direct impact on leptin that in turn, impacts blood pressure.
authors.affiliation: Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, United States; Judge Baker Children's Center, Harvard Medical School, Boston, MA, United States. Electronic address: Judith.crowell@stonybrookmedicine.edu.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Crowell
authors.affiliation: Judge Baker Children's Center, Harvard Medical School, Boston, MA, United States; Boston VA Healthcare System, Boston, MA, United States.
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Davis
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States; Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Kyoung Eun
authors.initials: KE
authors.lastname: Joung
authors.affiliation: Judge Baker Children's Center, Harvard Medical School, Boston, MA, United States.
authors.forename: Nicole
authors.initials: N
authors.lastname: Usher
authors.affiliation: Judge Baker Children's Center, Harvard Medical School, Boston, MA, United States; Suffolk University, Boston, MA, United States.
authors.forename: Sean-Patrick
authors.initials: SP
authors.lastname: McCormick
authors.affiliation: Boston College, Boston, MA, United States.
authors.forename: Eric
authors.initials: E
authors.lastname: Dearing
authors.affiliation: Boston VA Healthcare System, Boston, MA, United States; Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
authors.forename: Christos S
authors.initials: CS
authors.lastname: Mantzoros
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D004032:Diet; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D000959:Antihypertensive Agents; D020738:Leptin
keywords: Blood pressure; Childhood adversity; Hypertension; Leptin; Obesity