Abstract
BACKGROUND: There is little evidence regarding the relationship of child maltreatment with chronic inflammatory gastrointestinal diseases and its underlying pathways.
OBJECTIVE: To investigate the association of child maltreatment with chronic inflammatory gastrointestinal diseases and its underlying pathways.
PARTICIPANTS AND SETTING: An ambispective cohort analysis using data from the UK Biobank.
METHODS: We utilized a national cohort study from the UK to evaluate the associations of child maltreatment and its five subtypes with incident chronic inflammatory gastrointestinal diseases, assessing the mediated role of lifestyles, mental disorders, and inflammation indicators.
RESULTS: A total of 121,632 participants who completed the child maltreatment assessment were included in analyses. Compared to participants without child maltreatment history, those exposed to three or more subtypes had an increased risk of developing chronic inflammatory gastrointestinal diseases, with an adjusted hazard ratio (HR) of 1.49 (95 % CI: 1.36-1.62). All five subtypes of child maltreatment were associated with elevated incident chronic inflammatory gastrointestinal diseases with the strongest estimation for physical neglect (HR: 1.43, 95 % CI: 1.31-1.55). Moreover, chronic inflammatory gastrointestinal diseases induced by child maltreatment were attributed to chronic gastroduodenitis and gastroduodenal ulcer. Furthermore, child maltreatment was associated with lifestyles, mental disorders, and inflammation indicators, of which educational level, smoking status, anxiety, depression, C-reactive protein, white blood cell, neutrophil, and eosinophil partially mediated the associations of child maltreatment and chronic inflammatory gastrointestinal diseases.
CONCLUSIONS: Child maltreatment and its subtypes were associated with increased incident chronic inflammatory gastrointestinal diseases, especially for the upper gastrointestinal tract, involving the mediating role of lifestyles, mental disorders, and systemic inflammation.