Childhood Maltreatment Is an Independent Risk Factor for Prediabetic Disturbances in Glucose Regulation

Abstract

aims: Childhood maltreatment (CM) is shown to be associated with obesity and depression. However, the relationship of CM to prediabetic state is much less studied. We tested the hypothesis that CM increases the risk for prediabetic state due to glucose intolerance, reduced insulin sensitivity, and beta cell function.Methods: Oral glucose tolerance test (OGTT)-derived metabolic parameters of glucose tolerance, insulin sensitivity, and beta cell function were measured in 121 participants aged 19-60 years. CM exposure was measured using the Childhood Trauma Questionnaire. Blood samples were collected to measure the inflammatory factors. results: After controlling for age, race, gender, education, and depression, about 15% higher glucose area under the OGTT curve was observed in the CM group. CM individuals also exhibited impaired insulin sensitivity manifested by the Matsuda index and homeostasis model assessment of insulin resistance, which were correlated with CM severity after adjusting for depression. CM group showed approximately 50% lower disposition index. C-reactive protein and tumor necrosis factor-α levels were greater in the CM group vs. the non-CM group, and both were correlated with CM severity (r = 0.21, 0.23, respectively, both p < 0.05). Multiple regression analyses revealed that CM contributed to reduced insulin sensitivity and lower disposition index independent of depression and visceral fat mass. conclusion: These data suggest an important relationship between CM and increased risk for prediabetic state due to glucose intolerance, impaired insulin sensitivity, and beta cell function. Our findings indicate that CM appears to be an independent risk factor for developing prediabetes.

Depression precedes, but does not follow, gestational diabetes

“…Thus, trauma appears to be a more far‐reaching determinant of both physiological inflammation and psychiatric disturbance, as compared to history of mental illness alone. This result is in accordance with previous findings .…”

“…It may be that trauma history affects the efficiency of clearing a glucose load, and that this effect becomes more evident at the tail end of the OGTT curve, where some subjects may have completely cleared the load and others still manifest serum glucose levels above normal. Impaired glucose clearance, and not elevated fasting serum glucose, has also been reported in association with childhood trauma in the general adult population . This work, together with our own, suggests that the functions of setting the baseline fasting blood glucose and of clearing a glucose load may be separable.…”

“…In the present work, we were able to identify an association between depression history and need for insulin in pregnancy, and between history of trauma and impaired tolerance of glucose load in pregnancy, but no association of either with fasting serum glucose. The latter result has been reported elsewhere as well , but the physiological mechanisms underlying this effect remain unexplored. Animal studies that could identify specific signaling cascades that may lead from specific types of adverse experiences to elevations in fasting glucose vs. glucose load tolerance vs. insulin secretion would be an important addition to the literature.…”

Response to: Commentary: Sex Differences in the Peripheral Immune System in Patients with Depression

“…Another issue raised by Breidenstein et al is the role of psychosocial stress as a possible mediator in the relationship between inflammation and MDD, as well as the hypothalamic–pituitary–adrenal (HPA) axis in the pathogenesis of MDD. Two other studies from our group have suggested that childhood maltreatment is positively correlated with elevated inflammatory markers ( 9 , 10 ). Our observations were consistent with Mondelli et al’s reports ( 11 ) that psychosocial stress was one of the main factors determining neuroinflammation.…”

Early-Life Adversity, Systemic Inflammation and Comorbid Physical and Psychiatric Illnesses of Adult Life

“…However, it is still unclear if and how the effect of maltreatment on obesity could be modified through intervention. Li et al (2017) showed that childhood maltreatment is an independent risk factor for developing pre-diabetes. They recruited 121 participants from the general population, either with (n = 69) or without history of childhood maltreatment (n = 52).…”