title: Positive Psychosocial Factors in Childhood Predicting Lower Risk for Adult Type 2 Diabetes: The Cardiovascular Risk in Young Finns Study, 1980-2012.
abstract: BACKGROUND
  Type 2 diabetes is a public health concern, but psychosocial factors that may protect against the disease are unknown. This study examines whether a positive psychosocial environment in childhood is associated with lower risk for Type 2 diabetes in adulthood or healthier glucose trajectories over the life course, and whether BMI mediates the associations.
  
  
  METHODS
  A cohort of 3,596 Finnish children was followed into adulthood over 32 years. An overall positive psychosocial score, consisting of six subdomains, was measured at study baseline (1980). Relative risk ratios and multilevel growth curve modeling were used to examine associations of the psychosocial score with Type 2 diabetes (2012) and glucose trajectories (1986-2012). The mediating effect by BMI was examined using mediation analysis. The analyses were conducted between June 2015 and January 2016.
  
  
  RESULTS
  There was a 21% decrease in the rate of Type 2 diabetes (relative risk ratio, 0.79; 95% CI=0.66, 0.94) for each 1-SD increase in the positive psychosocial score after adjustment for childhood cardiovascular risk factors and dietary behaviors. Adult BMI mediated 52% and weight gain mediated 25% of the association. The growth curve model showed healthier glucose trajectories (age X psychosocial score interaction, b= -0.01; p=0.010) for participants with higher versus lower positive psychosocial score in childhood.
  
  
  CONCLUSIONS
  Positive psychosocial environment in childhood seems to have beneficial influences on the risk for Type 2 diabetes over the life span. RCTs will be required to see if interventions directed at early-life circumstances are warranted.
authors.affiliation: Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland. Electronic address: laura.pulkki-raback@helsinki.fi.
authors.forename: Laura
authors.initials: L
authors.lastname: Pulkki-Råback
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Christian
authors.initials: C
authors.lastname: Hakulinen
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Lipsanen
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Kubzansky
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Unit of Psychology, University of Oulu, Oulu, Finland.
authors.forename: Mirka
authors.initials: M
authors.lastname: Hintsanen
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Kateryna
authors.initials: K
authors.lastname: Savelieva
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Anna
authors.initials: A
authors.lastname: Serlachius
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute and Royal Children's Hospital, Melbourne, Australia.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Sabin
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute and Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: David P
authors.initials: DP
authors.lastname: Burgner
authors.affiliation: Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.affiliation: Department of Pediatrics, University of Helsinki, Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Jokinen
authors.affiliation: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Tapani
authors.initials: T
authors.lastname: Rönnemaa
authors.affiliation: Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: Vera
authors.initials: V
authors.lastname: Mikkilä
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Jula
authors.affiliation: Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.affiliation: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Jorma
authors.initials: J
authors.lastname: Viikari
authors.affiliation: Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Keltikangas-Järvinen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Raitakari
authors.affiliation: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires