Akasaki, Mifuyu;
(2022)
Adverse childhood experiences and coronary heart disease:
investigation of neuroendocrine and autonomic nervous
systems pathways.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Findings of the association of adverse childhood experiences (ACEs) with coronary heart disease (CHD) are inconsistent. Further, the underlying biological mechanism remains unclear. Accordingly, my PhD examined two hypothesised biological pathways linking ACEs and CHD: the neuroendocrine and the autonomic nervous systems. Data were from two longitudinal observational studies, the Whitehall II study (WHII), in which I carried out an analysis on how non-response influences mortality, and the National Child Development Study (NCDS). I applied a methodology which allowed for different effect sizes for each ACE, while still being able to assess the cumulative effect of ACEs. Cox proportional hazard models were used to examine the association between 14 retrospectively collected ACEs and incident CHD using WHII with an average follow-up of 12.9 years. No dose-response effect was observed, with a 6.0% (95% confidence interval: -13%, 1%) reduction in CHD in the absence of ACEs. Random effects models were used to examine associations between ACEs and diurnal cortisol patterns, an indicator of the neuroendocrine system, drawn from six saliva samples in WHII, and two samples in NCDS. Increasing number of ACEs showed no association with overall cortisol secretion, or awakening response, but the cortisol on waking decreased with the flatter diurnal slope at a mean age of 65.9 (SD 6.0) in WHII. There was no association between prospectively measured ACEs and cortisol at age 44/45 years in NCDS. Finally, the association between ACEs and heart rate variability (HRV), a marker of the autonomic nervous system, was assessed in WHII. I used random effects models to examine three measures over 10 years follow-up from age 55.3 (SD 6.0). There was no association between ACEs with HRV. Prevention or mitigation of ACEs are unlikely to impact rates of CHD, but may have benefits for health outcomes relating to the neuroendocrine system.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Adverse childhood experiences and coronary heart disease: investigation of neuroendocrine and autonomic nervous systems pathways |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute UCL > Provost and Vice Provost Offices > School of Education UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10158286 |
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