Table 2. Association Between the Number of ACEs and Subsequent Chronic Diseases in Adulthood.
| Chronic disease | OR (95% CI) by No. of ACEs | P value for trend | ||||
|---|---|---|---|---|---|---|
| 0 | 1 | 2 | 3 | ≥4 | ||
| Model 1a | ||||||
| Hypertension | 1 [Reference]b | 1.06 (0.95-1.18) | 1.14 (1.01-1.28) | 1.06 (0.93-1.20) | 1.00 (0.88-1.13) | .98 |
| Dyslipidemia | 1 [Reference] | 1.00 (0.85-1.18) | 1.09 (0.92-1.29) | 1.06 (0.88-1.28) | 1.06 (0.88-1.26) | .37 |
| Diabetes | 1 [Reference] | 0.97 (0.83-1.12) | 1.05 (0.90-1.23) | 1.00 (0.84-1.19) | 1.10 (0.94-1.29) | .18 |
| Heart disease | 1 [Reference] | 0.96 (0.81-1.12) | 1.05 (0.89-1.24) | 1.18 (0.98-1.41) | 1.09 (0.92-1.30) | .047 |
| Stroke | 1 [Reference] | 0.84 (0.57-1.25) | 1.31 (0.90-1.90) | 1.72 (1.16-2.54) | 1.64 (1.12-2.38) | <.001 |
| Chronic lung disease | 1 [Reference] | 1.03 (0.85-1.26) | 1.42 (1.16-1.73) | 1.91 (1.55-2.36) | 2.32 (1.91-2.82) | <.001 |
| Asthma | 1 [Reference] | 1.02 (0.75-1.39) | 1.41 (1.04-1.91) | 1.87 (1.36-2.56) | 2.20 (1.64-2.95) | <.001 |
| Liver disease | 1 [Reference] | 0.94 (0.72-1.24) | 1.35 (1.03-1.77) | 1.25 (0.92-1.69) | 1.58 (1.20-2.09) | <.001 |
| Cancer | 1 [Reference] | 1.03 (0.63-1.69) | 1.24 (0.75-2.04) | 0.80 (0.43-1.49) | 1.26 (0.75-2.11) | .59 |
| Digestive disease | 1 [Reference] | 1.33 (1.15-1.54) | 1.60 (1.38-1.85) | 1.93 (1.64-2.26) | 2.56 (2.20-2.97) | <.001 |
| Kidney disease | 1 [Reference] | 1.27 (1.01-1.60) | 1.42 (1.12-1.80) | 1.62 (1.26-2.09) | 2.10 (1.66-2.65) | <.001 |
| Arthritis | 1 [Reference] | 1.12 (0.99-1.27) | 1.51 (1.32-1.72) | 1.80 (1.56-2.07) | 2.26 (1.98-2.59) | <.001 |
| Psychiatric disease | 1 [Reference] | 0.82 (0.49-1.37) | 1.17 (0.71-1.94) | 1.31 (0.76-2.25) | 2.31 (1.45-3.68) | <.001 |
| Memory-related disease | 1 [Reference] | 1.13 (0.73-1.74) | 1.53 (1.00-2.34) | 1.48 (0.92-2.37) | 2.08 (1.37-3.17) | <.001 |
| Model 2c | ||||||
| Hypertension | 1 [Reference] | 1.02 (0.89-1.18) | 1.09 (0.95-1.26) | 0.98 (0.83-1.15) | 0.85 (0.73-1.00) | .051 |
| Dyslipidemia | 1 [Reference] | 1.04 (0.85-1.26) | 1.16 (0.95-1.43) | 1.17 (0.93-1.48) | 1.27 (1.02-1.59) | .01 |
| Diabetes | 1 [Reference] | 1.02 (0.85-1.23) | 1.16 (0.96-1.40) | 1.01 (0.81-1.26) | 1.16 (0.94-1.43) | .17 |
| Heart disease | 1 [Reference] | 0.96 (0.79-1.16) | 1.05 (0.86-1.28) | 1.22 (0.98-1.52) | 1.18 (0.95-1.46) | .02 |
| Stroke | 1 [Reference] | 0.88 (0.54-1.42) | 1.25 (0.78-2.00) | 1.53 (0.93-2.51) | 1.55 (0.97-2.50) | .006 |
| Chronic lung disease | 1 [Reference] | 0.98 (0.78-1.24) | 1.33 (1.05-1.68) | 1.70 (1.32-2.18) | 2.01 (1.59-2.55) | <.001 |
| Asthma | 1 [Reference] | 0.95 (0.66-1.38) | 1.36 (0.95-1.96) | 1.73 (1.18-2.53) | 2.23 (1.56-3.19) | <.001 |
| Liver disease | 1 [Reference] | 0.84 (0.61-1.15) | 1.23 (0.91-1.68) | 1.15 (0.81-1.63) | 1.45 (1.05-2.01) | .002 |
| Cancer | 1 [Reference] | 0.99 (0.56-1.75) | 1.22 (0.68-2.19) | 0.79 (0.37-1.66) | 1.09 (0.57-2.09) | .92 |
| Digestive disease | 1 [Reference] | 1.40 (1.18-1.65) | 1.63 (1.37-1.95) | 2.04 (1.68-2.47) | 2.59 (2.16-3.11) | <.001 |
| Kidney disease | 1 [Reference] | 1.20 (0.92-1.56) | 1.22 (0.92-1.61) | 1.31 (0.97-1.78) | 1.98 (1.50-2.62) | <.001 |
| Arthritis | 1 [Reference] | 1.06 (0.91-1.23) | 1.42 (1.22-1.66) | 1.62 (1.37-1.93) | 1.97 (1.67-2.33) | <.001 |
| Psychiatric disease | 1 [Reference] | 0.73 (0.39-1.34) | 1.27 (0.72-2.24) | 1.35 (0.72-2.53) | 2.28 (1.31-3.94) | <.001 |
| Memory-related disease | 1 [Reference] | 1.07 (0.63-1.83) | 1.34 (0.78-2.27) | 1.46 (0.82-2.59) | 1.99 (1.18-3.37) | .003 |
Abbreviations: ACE, Adverse Childhood Experience; OR, odds ratio.
a
Model 1 was the crude model.
b
Reference: No ACE exposure.
c
Model 2 was adjusted for age, sex, ethnicity, marital status, educational level, rural or urban residence, smoking and drinking status, annual per capita household expenditure level, and childhood economic hardship.