Early Childhood Adversity and HbA1c Levels: A Study of Puerto Rican Young Adults in Two Sites Open Access

Abstract

Background: Adverse childhood experiences have been linked to a variety of poor health outcomes in adulthood, but gaps in the literature exist regarding their association with diabetes. To date few studies have focused on racial and ethnic minorities, have used prospectively collected ACE data as opposed to retrospective self-reporting, or have used laboratory-measured HbA1c data. This study examined the association between both prospectively and retrospectively reported ACEs and HbA1c levels measured in young adulthood. The study population is a sample of Puerto Rican young adults living in either Puerto Rico or the South Bronx. 

 

Methods: The Boricua Youth Study (BYS) is a longitudinal cohort study of Puerto Rican-identifying households living in the South Bronx, New York, and San Juan, Puerto Rico. A follow-up study was conducted on a sample of young adults in this cohort, in which they provided retrospectively collected ACE data and a blood sample to measure HbA1c (BYS-Health Assessment). Unadjusted and adjusted linear regressions were performed for the association between prospective and retrospective ACE score and HbA1c. Separate analyses examined the association between the presence of ACEs in the child maltreatment subgroup only and HbA1c. All models were subsequently stratified by site.

 

Results: This study found null associations overall between ACE score and HbA1c in young adulthood and between child maltreatment ACEs and HbA1c in both the unstratified and site-stratified analyses in this sample. For example, compared to individuals with 0 ACEs, individuals with 4+ ACEs had an adjusted β=0.04, 95% CI: -0.15 to 0.23 (prospective model) and an adjusted β=0.02, 95% CI: -0.16 to 0.19 (retrospective model).

 

Conclusion: These results suggest that in this population, both cumulative adversity and child maltreatment do not affect risk of diabetes in young adulthood. Further research is needed to examine this association across different age groups in this population to ascertain the time course of the effect of child adversity on diabetes risk manifestation.  

Table of Contents

Introduction - 1

Methods - 5

Results - 9

Discussion - 12

References - 17

Tables & Figures - 21

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	adverse childhood experiences Latinx maltreatment Boricua Youth Study childhood adversity Hispanic Bronx stress adverse childhood events HbA1C diabetes Puerto Rican cardiometabolic Puerto Rico Latino San Juan BYS neglect ACEs abuse
Committee Chair / Thesis Advisor	Shakira Suglia, Emory University

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