gms | German Medical Science

Background: The relationship between childhood maltreatment (CM) and obesity is complex and modified by various factors including biological sex [1]. A recent population-based research including data from 4,006 individuals suggested a stronger association between CM and markers of obesity in women compared to men [2]. The present study aims to validate these findings in data of the German National Cohort (NAKO).

Methods: The NAKO is a country-wide population-based cohort study including >200,000 subjects recruited at 18 examination centers. For the present analyses we included data from 151,143 individuals (49.4% women). CM was assessed using the Childhood Trauma Screener (CTS), which captures exposure to five forms of CM and an overall score (CTS sum score) [3]. Anthropometric markers included body height, body weight, body mass index (BMI), waist circumference, relative fat mass (rFM), subcutaneous (SAT) and visceral adipose tissue (VAT). We conducted sex-stratified linear regression models adjusted for age, years of schooling and examination center to associate the CTS sum score as well as the five CTS subscales with the anthropometric markers.

Results: At least one CM was reported by 28.7% of the women and by 23.4% of the men. In women, the most frequent forms of CM were physical neglect (9.9%), emotional abuse (8.0%), and sexual abuse (8.0%). Men reported most frequently physical neglect (9.9%) and physical abuse (8.3%). The CTS sum score was inversely associated with body height in men (β= -0.08; 95% confidence interval = -0.10 to -0.06) but not in women (β= -0.03; 95%- CI = -0.12 to 0.11). Associations of the CTS sum score with body weight (women: β= 0.20; men β= 0.10), BMI (women: β= 0.08; men β= 0.05), waist circumference (women: β= 0.21; men β= 0.14), rFM (women: β= 0.07; men β= 0.04) and SAT (women: β= 0.10; men β= -0.01) were stronger in women compared to men. Associations of the CTS sum score with VAT were similar in women (β=0.28) and men (β=0.31). In women, emotional, physical, and sexual abuse showed the strongest associations with the obesity-related markers. In men, physical and emotional neglect were most strongly associated with a lower body height, while emotional and physical abuse showed the strongest associations with VAT.

Conclusion: We demonstrated sex-specific effects of CM exposure on anthropometric markers. Except for VAT, associations of CM with obesity-related traits were stronger in women than in men. This implicates, that CM may be associated with a higher obesity-related cardiometabolic risk in women than in men.

The authors declare that they have no competing interests.

The authors declare that a positive ethics committee vote has been obtained.