Table 4.
Associations between TCEs and incident T2DM by prevalent MetS, The Sister Study (2003–2019)
| MetS (yes) | MetS (no) | |||
|---|---|---|---|---|
| Sample size, n (%) | 3,449 (9.4) | 33,394 (90.6) | ||
| No. of cases of T2DM per person-years of follow-up* | 908/32,060 | 2,049/375,322 | ||
| Incidence per 10,000 person-years | 283/10,000 | 55/10,000 | ||
| TCE at age <18 years | % with TCE and HR (95% CI) of T2DM | |||
| No trauma | 45.9 | 1.00 (reference) | 50.2 | 1.00 (reference) |
| Any trauma | 54.1 | 1.07 (0.92, 1.25) | 49.8 | 1.08 (0.97, 1.19) |
| Psychological/emotional trauma | 37.1 | 1.09 (0.93, 1.29) | 33.3 | 1.11 (0.99, 1.24) |
| Household dysfunction | 19.4 | 1.06 (0.87, 1.30) | 18.0 | 1.06 (0.92, 1.22) |
| Sexual trauma | 18.3 | 0.96 (0.79, 1.18) | 15.8 | 1.18 (1.03, 1.35) |
| Physical trauma | 7.7 | 1.13 (0.86, 1.49) | 5.7 | 1.30 (1.07, 1.57) |
| Natural disaster | 3.9 | 1.28 (0.89, 1.84) | 3.2 | 1.17 (0.92, 1.49) |
| Major accident | 4.0 | 0.82 (0.56, 1.20) | 3.4 | 1.16 (0.89, 1.52) |
| Major illness | 3.8 | 1.45 (1.04, 2.02) | 2.6 | 1.28 (0.97, 1.67) |
| High versus low trauma category | 14.8 | 1.06 (0.88, 1.29) | 12.4 | 1.08 (0.94, 1.24) |
Models are adjusted for race/ethnicity (non-Hispanic White, Black/African American [non-Hispanic], and Hispanic/Latina), childhood region of residence (Northeast, Midwest, South, West, Puerto Rico or outside Puerto Rico and the United States), and childhood socioeconomic status (i.e., food insecurity while growing up, low educational attainment in childhood household, and low-income household). Bolded values indicate statistical significance at a two-sided P < 0.05. There was no evidence of effect modification by MetS (no TCE by MetS interaction terms were statistically significant at a two-sided P < 0.05).
There were 5,330 participants (n = 201 T2DM cases) with missing values for MetS for which MetS status was imputed. These participants are not included in the count of T2DM cases and person-years of follow-up in this table but are reflected in the distribution of TCEs and in the HRs. TCE, traumatic childhood experience; MetS, metabolic syndrome; T2DM, type 2 diabetes mellitus; HR, hazard ratio; CI, confidence interval.