Home > Association of adverse experiences and exposure to violence in childhood and adolescence with inflammatory burden in young people.

Rasmussen, Line Jee Hartmann and Moffitt, Terrie E and Arseneault, Louise and Danese, Andrea and Eugen-Olsen, Jesper and Fisher, Helen L and Harrington, HonaLee and Houts, Renate and Matthews, Timothy and Sugden, Karen and Williams, Benjamin and Caspi, Avshalom . (2019) Association of adverse experiences and exposure to violence in childhood and adolescence with inflammatory burden in young people. JAMA Pediatrics, Early online 11 p. doi: 10.1001/jamapediatrics.2019.3875

URL: https://jamanetwork.com/journals/jamapediatrics/fu...

Importance: Childhood stress exposure is associated with inflammation as measured by C-reactive protein (CRP) and interleukin 6 (IL-6). However, findings are inconsistent and effect sizes are small. The addition of soluble urokinase plasminogen activator receptor (suPAR), a new biomarker of chronic inflammation, may improve measurement of stress-related inflammatory burden.

Objectives: To assess whether exposure to adverse experiences, stress, and violence is associated with an increase in suPAR levels in young people and to test the hypothesis that measuring suPAR in addition to CRP or IL-6 levels improves the assessment of the inflammatory burden associated with early-life stress.

Design, Setting, and Participants: This cohort study included 1391 participants from a 1994 to 1995 birth cohort of twins from the nationally representative Environmental Risk Longitudinal Twin Study in the United Kingdom. Participants were followed up until 18 years of age (93% retention). Plasma samples were analyzed in July 2018, and statistical analysis was performed from October 1, 2018, to May 31, 2019.

Exposures: Adverse childhood experiences and childhood and adolescent experience of stress and violence exposure.
Main Outcomes and Measures: Plasma CRP, IL-6, and suPAR levels at 18 years of age.

Results: Among 1391 young people (mean [SD] age, 18.4 [0.36] years; 733 [52.7%] female), those who had been exposed to stressful experiences had elevated suPAR levels by 18 years of age after controlling for sex, body mass index, and smoking: 0.03-ng/mL (95% CI, 0.01-0.05 ng/mL) increase in suPAR per each additional adverse childhood experience, 0.09-ng/mL (95% CI, 0.01-0.17 ng/mL) increase in suPAR per each additional severe childhood experience of stress or violence, and 0.04-ng/mL (95% CI, -0.02 to 0.10 ng/mL) increase in suPAR per each additional severe adolescent experience of stress or violence. Individuals exposed to multiple types of violence in both childhood and adolescence had 0.26-ng/mL (95% CI, 0.07-0.45 ng/mL) higher suPAR levels compared with children who did not experience stress or violence. These stress-exposed young people were significantly more likely to have elevated suPAR levels at 18 years of age even if they did not have elevated CRP or IL-6 levels. Measuring suPAR in addition to CRP or IL-6 increased the association between stress exposure and inflammatory burden. For example, after adjusting for CRP and IL-6 levels, each additional adverse childhood experience was associated with a 0.05-mL (95% CI, 0.03-0.07 ng/mL) increase in suPAR, each additional severe childhood experience of stress or violence was associated with a 0.14-ng/mL (95% CI, 0.06-0.22 ng/mL) increase in suPAR, and each additional severe adolescent experience of stress or violence was associated with a 0.10-ng/mL (95% CI, 0.04-0.16 ng/mL) increase in suPAR.

Conclusions and Relevance: The results suggest that adult inflammation is associated with childhood exposure to stress. Adding information about suPAR to traditional biomarkers of inflammation may improve the measurement of inflammatory burden associated with exposure to stress and violence.


Item Type:Evidence resource
Drug Type:Alcohol or other drugs in general
Intervention Type:AOD disorder, AOD prevention, AOD disorder harm reduction
Date:4 November 2019
Pages:11 p.
Page Range:pp. 1-11
Volume:Early online
EndNote:View
Subjects:E Concepts in biomedical areas > General life processes (physiology)
J Health care, prevention and rehabilitation > Risk and protective factors > Risk factors
L Social psychology and related concepts > Marital relations > Family and kinship > Family relations > Family role
MM-MO Crime and law > Crime and violence > Substance related violence
MM-MO Crime and law > Crime and violence > Crime against persons (assault / abuse / intimidation)
T Demographic characteristics > Child
T Demographic characteristics > Adolescent / youth (teenager / young person)
T Demographic characteristics > Young adult

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