High adverse childhood experience exposure (≥5) significantly increased the risk of incident cardiovascular disease compared to low exposure (0-2) in adults with CKM syndrome (HR 1.29; 95% CI 1.07-1.55).
Cohort (n=6,113)
Yes
Does adverse childhood experiences exposure increase incident CVD events in Chinese adults with CKM syndrome?
Cumulative adverse childhood experiences independently increase the risk of incident cardiovascular disease in adults with CKM syndrome, with the effect partially mediated by depression.
Effect estimate: HR 1.29 (95% CI 1.07-1.55)
Adverse childhood experiences (ACE) significantly escalate the risk of cardiovascular disease (CVD). However, their specific impact on individuals suffering from cardiovascular kidney metabolic (CKM) syndrome remains largely unexplored. This study examined ACE-CVD associations and depression's mediating role in this high-risk population. This longitudinal study included 6,113 Chinese adults with CKM syndrome (stages 0-3) from the China Health and Retirement Longitudinal Study (CHARLS). Baseline characteristics were established in 2011, while ACE data were retrieved from the 2014 Life History Survey. Incident CVD events were monitored during follow-up waves in 2013, 2015, and 2018. Cox models assessed ACE-CVD associations, and mediation analysis quantified depression's contribution. During follow-up, 931 incident CVD cases occurred. Compared to low ACE exposure (0-2), medium (3-4) and high (≥ 5) ACE groups showed significantly elevated CVD risks (HR = 1.22, 95% CI: 1.05-1.41; HR = 1.29, 95% CI: 1.07-1.55). Each 1-point increase in total ACE score conferred 7% higher CVD risk (HR = 1.07, 95% CI: 1.03-1.10), with intrafamilial ACEs showing stronger associations (HR = 1.08, 95% CI: 1.04-1.13). A nonlinear dose-response relationship was identified (P < 0.001). Depression symptoms mediated 14.3% (95% CI: 4.6%-24.2%) of the total association. Among Chinese adults with CKM syndrome, cumulative ACE exposure, particularly intrafamilial adversities, independently increases CVD risk in a dose-response manner, partially mediated by depression. Integrating ACE screening and depression management could enhance cardiovascular prevention in this population.
Sun et al. (2026) conducted a cohort in Cardiovascular kidney metabolic (CKM) syndrome stages 0 to 3 (n=6,113). Adverse childhood experiences (ACE) vs. Low ACE exposure (0-2) was evaluated on Incident CVD events (HR 1.29, 95% CI 1.07-1.55). High adverse childhood experience exposure (≥5) significantly increased the risk of incident cardiovascular disease compared to low exposure (0-2) in adults with CKM syndrome (HR 1.29; 95% CI 1.07-1.55).