Inflammation and Early-Life Abuse in Women

Background: Abuse in childhood and adolescence may affect risks of diabetes and cardiovascular disease later in life. Although mechanisms underlying these relationships are unclear, chronic stress may lead to dysregulation of immune function and chronic inflammation. Purpose: To evaluate associations between early-life physical and sexual abuse and blood levels of inflammatory markers in adulthood among 702 members of the Nurses' Health Study II. Methods: Abuse in childhood (before age 11 years) and adolescence (ages 11-17 years) was self-reported in 2001. Plasma samples collected in 1996-1999 were assayed for C-reactive protein (CRP); interleukin (IL)-6; and the soluble fraction of tumor necrosis factor alpha receptor 2 in 2001, 2009, and 2010. Results: Mean age at blood collection was 43.9 years. Moderate or severe physical abuse was reported by 35.3% of participants; 22.7% reported unwanted sexual touching and 9.8% reported forced sex. Plasma levels of CRP and IL-6 were higher in women reporting sexual abuse in adolescence compared to those reporting no abuse (p = 0.04 and 0.03, respectively) in analyses adjusted for confounders including age and childhood adiposity. Inflammatory marker levels similarly were elevated in women reporting sexual abuse during childhood, but results were not significant. Relationships largely persisted after further adjustment for potential mediators such as adult BMI and smoking. Physical abuse during childhood and/or adolescence was not consistently associated with inflammatory marker levels. Conclusions: Chronic inflammation may be one mechanism through which sexual abuse may affect future risk of physical and psychological disorders. (Am J Prev Med 2012;43(6):611-620) (C) 2012 American Journal of Preventive Medicine