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Childhood abuse ups risk of incident SLE in women

12 Dec 2019

Women who had experienced physical and emotional abuse during childhood appear to have a significantly higher risk of systemic lupus erythematosus (SLE) than those who had not, a recent study reveals. Exposure to childhood adversity may be a risk factor for SLE development.

Ninety-four cases of incident SLE were recorded among 67,516 women included in this study.

Adjusted models showed that exposure to the highest vs lowest physical and emotional abuse correlated with 2.57 times higher risk of SLE (95 percent confidence interval [CI], 1.30–5.12). Seventeen percent (p<0.0001) of SLE risk associated with abuse was driven by depression and 23 percent (p<0.0001) by post-traumatic stress disorder (PTSD).

There was no statistically significant association found between sexual abuse (highest vs lowest exposure: hazard ratio, 0.84, 95 percent CI, 0.40–1.77) and SLE risk.

This study obtained data from the Nurses’ Health Study II, a cohort of US female nurses enrolled in 1989, followed with biennial questionnaires. Childhood physical and emotional abuse was measured using the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire and sexual abuse using the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale, both administered in 2001.

The investigators identified incident SLE (≥4 American College of Rheumatology 1997 classification criteria) through 2015. They used multivariable Cox regression models to examine the association between childhood abuse and SLE, accounting for potential confounders (eg, parental education, occupation, home ownership) and mediators (eg, depression, PTSD).

“Exposure to severe stressors may alter immune function and augment inflammation and cytokine release, increasing risk of autoimmune disease,” according to the investigators.

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