Association of pre-adolescent adverse childhood experiences with adolescent cholesterol levels: findings from the A-CHILD longitudinal study.

BACKGROUND

Adverse childhood experiences (ACEs) are well known to be associated with poor health outcomes in adulthood. However, its effect on adolescent health remains underexplored, particularly, how cumulative ACE exposure during childhood influences cholesterol levels in adolescence. This study aims to investigate the longitudinal association between cumulative ACE exposure during elementary school and cholesterol levels in middle school using population-based longitudinal study.

METHOD: We used longitudinal data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study which followed students from elementary through junior high school in Adachi City, Tokyo from 2015 to 2022 (N = 1,460). ACE items (single parenthood, parental history of psychiatric disorders, parental neglect, physical abuse, psychological abuse, witness of domestic violence, and poverty) were measured at each wave in grades 1, 2, 4, and 6. Cumulative ACE was measured by experiencing at least 1 ACE in any of the grades. Cholesterol was measured in grade 8, using blood samples obtained during a school health checkup. We evaluated the association between cumulative ACE and exposure to each ACE with cholesterol levels using linear regression analyses, adjusting for sex, maternal age, parental education, and child behavioral and emotional difficulties.

RESULTS

Out of 1,460 adolescents, 876 (60%) experienced at least 1 ACE during elementary school. Total cumulative effect of ACEs on cholesterol was not observed. Physical abuse and poverty were associated with reduced high-density lipoprotein (HDL) (β = -1.54, 95% confidence interval (CI); -3.07, 0.01 and β = -1.96, 95% CI; -3.34, -0.59, respectively), adjusting for confounders.

CONCLUSION

Experiencing physical abuse and poverty in elementary school were associated with lower HDL cholesterol in adolescence.