Background

ACEs include abuse, neglect and other events that threaten a child’s safety or sense of security. ACEs can predict obesity and cardiometabolic disease, but mechanisms underlying these links are poorly understood. Hispanic teens may be more vulnerable to the deleterious effects of ACEs on metabolic health. We evaluated the association of ACEs with stress physiology and metabolic risk in teens at-risk for adult obesity and determined if Hispanic ethnicity moderates this relation.

Methods

Participants (N=92) were 14.2+/-1.6y olds (50% male; 33% Hispanic) at-risk for adult obesity (BMIz 1.6+/-0.6). ACEs lifetime presence was assessed with the Schedule for Affective Disorders & Schizophrenia for School-Age Youth. Stress physiology was measured as heart rate (HR) and blood pressure (DBP/SBP) responses (area under the curve) to the Trier Social Stress Test (TSST), a validated lab stressor. Metabolic risk was determined from fasting insulin/glucose and insulin resistance (HOMA-IR).

Results

62% of White v. 68% of Hispanic teens reported lifetime presence of any ACE (p=.57). 17% of White v. 21% of Hispanic teens experienced ACEs involving abuse (p=.59). Compared to no ACEs, those with ACEs had higher TSST HR (p<.01) and DBP (p<.05), accounting for age, sex, BMIz, and ethnicity. Ethnicity moderated the association of ACEs involving abuse with glucose (p=.02). Hispanic teens with abuse had higher fasting glucose (87+/-3mg/dL) compared to those without abuse (79+/-1mg/dL) and White teens with (78+/-2mg/dL) and without abuse (80+/-1mg/dL). There were no significant effects for SBP, insulin or HOMA-IR.

Conclusions

In teens at risk for adult obesity, having any ACE was related to HR and DBP response to a stressor. In Hispanic teens only, experiencing ACEs involving abuse was tied to higher fasting glucose. Stress physiology may play a role in explaining the ACEs-obesity/cardiometabolic disease link. Follow-up is needed to understand why Hispanic teens may be more vulnerable to metabolic consequences of abuse.