Adverse childhood experiences, social support, and cardiovascular-kidney-metabolic syndrome: evidence from two national cohorts

BackgroundThe association between adverse childhood experiences (ACEs) and cardiovascular-kidney-metabolic (CKM) syndrome, as well as the role of social support in this association, has not been elaborated. MethodsParticipants with complete information from the Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS) were included. In the main analysis, CKM stages 3 - 4 were classified as advanced CKM, and logistic regression was used to analyze the relationship between ACEs and advanced CKM. Pooled effects were determined through random-effects meta-analysis, with Cochrans Q test value and I2 statistic reported to assess heterogeneity. Mediation analysis was performed to investigate the mediating role of social support in this association. ResultsThe study included 6100 and 9722 eligible participants from the HRS and CHARLS, respectively. After adjusting for covariates, compared to the participants without ACEs, those who experienced more ACEs had a higher risk of advanced CKM (in participants who experienced 1 ACEs: pooled OR = 1.12, 95%CI:0.95 - 1.32, P = 0.168; 2 ACEs: pooled OR = 1.25, 95%CI:1.11 - 1.41, P < 0.001; [&ge;] 3 ACEs: pooled OR = 1.31, 95%CI:1.18 - 1.45, P < 0.001). Additionally, social support mediated 2.1% and 11.8% the association between ACEs and CKM syndrome in the CHARLS and HRS cohorts, respectively. ConclusionWe for the first time reported that ACEs were significantly associated with CKM syndrome in the general population. Furthermore, our results suggest that social support plays a partial mediating role in this relationship.