Child abuse is related to inflammation in mid-life women: role of obesity.

OBJECTIVE: Elevated inflammation biomarkers are associated with incident cardiovascular disease. Several studies suggest that childhood abuse may be associated with inflammation later in life. This study examined whether childhood abuse predicted elevated levels of C-reactive protein (CRP) and whether the association was due to body size.

METHODS: Participants were 326 (104 Black, 222 White) women from the Pittsburgh site of the Study of Women's Health Across the Nation (SWAN). SWAN included a baseline assessment of pre-menopausal or early peri-menopausal women in mid-life (mean age=45.7), and CRP, depressive symptoms, body mass index (BMI), and other covariates were measured over 7 annual follow-up visits. The Childhood Trauma Questionnaire, a standardized measure that retrospectively assesses abuse and neglect in childhood and adolescence, was administered at year 8 or 9 of follow-up.

RESULTS: Approximately 37% of the participants reported a history of abuse or neglect. Generalized estimating equations showed that sexual and emotional abuse, emotional and physical neglect, and the total number of types of abuse were associated with higher CRP levels over 7 years, adjusting for race, age, education, smoking status, use of hormone therapy, depressive symptoms, occurrence of heart attack or stroke, and medications for hypertension. The coefficients for indirect effects for emotional and sexual abuse, physical neglect, and total number of types of abuse on CRP levels through BMI were significant. A history of emotional abuse and neglect was related to percent change in CRP over the 7 years but not through percent change in BMI over the 7 years.

CONCLUSION: A history of childhood abuse and neglect retrospectively reported is related to overall elevated inflammation in mid-life women, perhaps through obesity. A history of some types of abuse and neglect (emotional) may be related to change in inflammation, independent of simultaneously measured change in BMI.