Adverse Childhood Experiences and Systemic Inflammation in Adults in the United States

Thesis (Master's)--University of Washington, 2020Background and significance: Adverse childhood experiences (ACEs) are associated with poor behavioral and physical health outcomes in adulthood. Though not fully elucidated, systemic inflammation is one mechanism through which ACEs are thought to affect health outcomes in adulthood. The objective of this study was to assess the relationship between ACEs and systemic inflammation and if this relationship differed by participant sex, race/ethnicity, sexual orientation, or parent age, income, and education. Methods: The sample was the 9,161 participants who completed Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health and had a valid measurement for C-reactive protein (CRP), an indicator of systemic inflammation. The exposure was an ordinal ACE score developed from a 6-item questionnaire administered at Wave III of the study. Multivariable linear regression of log-transformed CRP (log CRP) concentration on ACE score was performed with covariates for adjustment and interaction. Results: ACE score was not significantly associated with log CRP in crude or adjusted linear regression models and no evidence of interaction was present. Discussion: These findings do not support an association between ACEs and systemic inflammation. This finding adds to the heterogeneous landscape of association of ACEs with CRP and emphasizes the need for consistent indicators of biological embedding to clarify the relationship between ACEs and poor health in adulthood