School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Psychoneuroendocrinology. 2021 Oct;132:105362. doi: 10.1016/j.psyneuen.2021.105362. Epub 2021 Jul 21.
Early life adversity is increasingly prevalent and associated with greater morbidity and mortality. It is hypothesised that the link between psychosocial early life adversity and poor health in adulthood is due to abnormal hypothalamic-pituitary-adrenal (HPA) axis functioning (often measured as cortisol patterning) and inflammation (often measured via c-reactive protein (CRP)). This study aimed to investigate the relationship between early life psychosocial adversity and cortisol patterning and CRP at 60-64 years of age.
The MRC National Survey of Health and Development (NSHD) was used. The analytic "cortisol sample" included 843 individuals and the "CRP sample" included 1150 individuals. Data on adversity experienced between ages 0-15 years were utilised to compose a cumulative childhood psychosocial early life adversity (ELA) score (0, 1, 2, 3+). CRP and salivary cortisol (waking, 30 min after waking, and evening) were collected at 60-64 years. Associations between the psychosocial ELA score and cortisol outcomes (cortisol awakening response (CAR), diurnal slope (DS), and evening and morning cortisol) were assessed using general linear regression. Tobit regression was used to assess the association between psychosocial ELA score and CRP. Adjustments were made for age at follow-up, sex, childhood maternal education, childhood paternal social class, childhood housing tenure, and birth weight. After testing for sex by ELA score interactions, analyses were repeated stratified by sex for the CRP sample.
In fully adjusted models, individuals who experienced the highest level of childhood psychosocial adversity (3+) had a 24.63 (-41.49, -7.76) % lower waking cortisol and a 7.30 (1.49, 13.12) % lower decline in cortisol across the day compared to those with a psychosocial ELA score of zero. In females, the highest level of childhood psychosocial adversity, compared to the lowest, was associated with 32.61 (2.98, 62.25) % higher CRP at 60-64 years, which attenuated to 20.38% (-9.38, 50.14) upon adjustment for measures of early life socioeconomic position. Conversely, the association between childhood psychosocial adversity and CRP in males was null.
Our results suggest that high-levels of psychosocial adversity in childhood might result in a lower morning cortisol and flatter DS in mid-to-late-adulthood. The finding that adversity was related to higher CRP in females but not males requires replication and further investigation.
早年生活逆境越来越普遍，与更高的发病率和死亡率有关。人们假设，心理社会早年逆境与成年后健康状况不佳之间的联系是由于下丘脑-垂体-肾上腺 (HPA) 轴功能异常（通常通过皮质醇模式测量）和炎症（通常通过 C 反应蛋白 (CRP) 测量）。本研究旨在调查 60-64 岁时早年心理社会逆境与皮质醇模式和 CRP 之间的关系。
使用 MRC 国家健康与发展调查 (NSHD)。分析中的“皮质醇样本”包括 843 人，“CRP 样本”包括 1150 人。利用 0-15 岁时经历的逆境数据，构成累积的儿童期心理社会早年逆境 (ELA) 评分（0、1、2、3+）。在 60-64 岁时采集 CRP 和唾液皮质醇（醒来时、醒来后 30 分钟和晚上）。使用一般线性回归评估心理社会 ELA 评分与皮质醇结果（皮质醇觉醒反应 (CAR)、日间斜率 (DS) 和早晚皮质醇）之间的关联。使用 Tobit 回归评估心理社会 ELA 评分与 CRP 之间的关联。调整了随访时的年龄、性别、儿童时期母亲的教育程度、儿童时期父亲的社会阶层、儿童时期的住房状况和出生体重。在检验了性别与 ELA 评分的相互作用后，对 CRP 样本按性别进行了重复分析。
在完全调整的模型中，与经历心理社会 ELA 评分最低的人相比，经历最高水平儿童期心理社会逆境（3+）的人醒来时皮质醇降低 24.63%（-41.49，-7.76%），全天皮质醇下降 7.30%（1.49，13.12%）。在女性中，与最低水平相比，儿童期心理社会逆境最高水平与 60-64 岁时 CRP 升高 32.61%（2.98，62.25%）相关，调整儿童期社会经济地位的测量值后，这一关联减弱至 20.38%（-9.38，50.14%）。相反，男性中儿童期心理社会逆境与 CRP 之间的关联为零。
我们的研究结果表明，儿童期高水平的心理社会逆境可能导致成年中期和后期早晨皮质醇水平降低和 DS 变平。逆境与女性 CRP 升高相关而与男性无关的发现需要进一步验证和研究。
