Data_Sheet_1_Associations Between Child Maltreatment, Inflammation, and Comorbid Metabolic Syndrome to Depressed Mood in a Multiethnic Urban Population: The HELIUS Study.docx

BackgroundChild maltreatment is a common negative experience and has potential long-lasting adverse consequences for mental and physical health, including increased risk for major depressive disorder (MDD) and metabolic syndrome. In addition, child maltreatment may increase the risk for comorbid physical health conditions to psychiatric conditions, with inflammation as an important mediator linking child maltreatment to poor adult health. However, it remains unresolved whether experiencing child maltreatment increases the risk for the development of comorbid metabolic syndrome to MDD. Therefore, we investigated whether child maltreatment increased the risk for comorbid metabolic syndrome to depressed mood. Subsequently, we examined whether C-reactive protein (CRP), as an inflammatory marker, mediated this association. In addition, we investigated whether effects differed between men and women.MethodsAssociations were examined within cross-sectional data from the multiethnic HELIUS study (N = 21,617). Adult residents of Amsterdam, Netherlands, self-reported on child maltreatment (distinct and total number of types experienced before the age of 16 years) as well as current depressed mood (PHQ-9 score ≥ 10), and underwent physical examination to assess metabolic syndrome. The CRP levels were assessed in N = 5,998 participants. Logistic and linear regressions were applied for binary and continuous outcomes, respectively. All analyses were adjusted for relevant demographic, socioeconomic, and lifestyle characteristics, including ethnicity.ResultsA higher number of maltreatment types as well as distinct types of emotional neglect, emotional abuse, and sexual abuse were significantly associated with a higher risk for current depressed mood. Child maltreatment was not significantly associated with the risk for metabolic syndrome in the whole cohort, nor within individuals with depressed mood. As child maltreatment was not significantly associated with the CRP levels, subsequent mediation analyses were not performed. No significant moderating effects by sex were observed.ConclusionIn this multiethnic urban cohort, child maltreatment was associated with a higher risk for depressed mood. Contrary to our expectations, child maltreatment was not significantly associated with an increased risk for metabolic syndrome, neither in the whole cohort nor as a comorbid condition in individuals with depressed mood. As the data were cross-sectional and came from a non-clinical adult population, longitudinal perspectives in relation to various stages of the investigated conditions were needed with more comprehensive assessments of inflammatory markers.

背景：儿童虐待是一种普遍的负面经历，可能对心理健康和身体健康产生长期的不利影响，包括增加重度抑郁症（MDD）和代谢综合征的风险。此外，儿童虐待可能增加合并生理健康条件至精神疾病的风险，其中炎症作为将儿童虐待与成年不良健康状态联系起来的重要中介因素。然而，尚不清楚经历儿童虐待是否会增加合并代谢综合征至MDD的风险。因此，我们研究了儿童虐待是否增加了合并代谢综合征至抑郁情绪的风险。随后，我们考察了作为炎症标志物的C反应蛋白（CRP）是否介导了这种关联。此外，我们还研究了男性与女性之间的效应是否存在差异。方法：在多民族HELIUS研究（N = 21,617）的横断面数据中考察了这些关联。荷兰阿姆斯特丹的成年居民自行报告了他们在16岁之前经历的儿童虐待（不同类型和总数）以及当前的抑郁情绪（PHQ-9评分≥10），并接受了体检以评估代谢综合征。在N = 5,998名参与者中评估了CRP水平。分别应用逻辑回归和线性回归对二元和连续结果进行分析。所有分析均调整了相关的人口统计学、社会经济和生活方式特征，包括种族。结果：虐待类型数量以及特定的情感忽视、情感虐待和性虐待类型与当前抑郁情绪的高风险显著相关。在整个人群中，儿童虐待与代谢综合征的风险无显著关联，在抑郁情绪的个体中也是如此。由于儿童虐待与CRP水平无显著关联，因此未进行后续的中介分析。没有观察到性别调节作用的显著影响。结论：在这项多民族城市队列研究中，儿童虐待与抑郁情绪的高风险相关。与我们的预期相反，儿童虐待与代谢综合征的风险增加无显著关联，无论是在整个人群中还是在抑郁情绪的个体中作为合并条件。由于数据是横断面且来自非临床成人人群，因此需要纵向视角，以研究调查条件的不同阶段，并进行更全面的炎症标志物评估。