Early life adversity and trajectories of cardiometabolic health, cognitive function and physical function: improving understanding of the mechanisms a

健康从早年就开始了。在幼年时期，健康家庭的孩子们会了解到，他们可以依靠照顾者来获得身体和情感上的健康。这使儿童能够发展行为和其他资产，使他们能够在以后的生活中维持自己的健康。当家庭安全网以一种或多种方式受到损害时，幼儿的情感和身体发育就会变得脆弱。早年的逆境是不利的心脏代谢健康的风险因素，以及认知和身体功能较差--健康老龄化的三个方面对长寿和老年保持独立性至关重要。然而，关于早期生活逆境产生不利健康后果的途径和机制仍然存在疑问。关于这一主题的大多数研究来自于成年后单一年龄健康测量的研究。这样的研究无法探索早期生活逆境和整个生命过程中健康变化之间的动态关系。我们将在纵向研究中对这一点进行调查，在3个队列中重复测量健康状况。使用重复的健康衡量标准将使我们能够评估一些人是否仍然对早期逆境对健康的影响具有弹性，一些较早年龄健康状况良好的人是否经历了中年健康状况的恶化，以及逆转的可能性，即中年健康状况的改善。成人经历的逆境(例如虐待或功能失调的关系)和资源(例如社会支持)的作用也仍然不确定。在所有三个队列中，我们将研究成年后的逆境和资源是否解释或改变早期逆境与健康轨迹之间的关系。吸烟和肥胖等风险因素在健康不平等的产生中发挥了作用，减少这些风险因素的干预措施将减少早期生活逆境对健康的不利影响。然而，这些证据大多来自对吸烟、肥胖等的单一测量。在所有三个队列中，我们将使用对吸烟、饮酒、体力活动、心理健康和人格特征的重复测量，并探索它们在早期生活逆境和后来健康之间的关系中所起的作用。我们的方法将使我们能够确定有害或促进健康的行为或心理轨迹。最后，文献中对早期生活逆境影响后来健康的生物学机制没有给予足够的重视。我们将评估两个生物学过程，DNA甲基化和皮质醇，在早期生活逆境和健康轨迹之间的关联中所起的作用。

Good health starts in early life. In early childhood, children in 'healthy' families learn that they can rely on their carers for their physical and emotional wellbeing. This allows the child to develop behaviours and other assets that will enable them to maintain their own wellbeing in later life. When the family safety net is compromised in one or more ways, the emotional and physical development of young children is vulnerable. Early life adversity is a risk factor for adverse cardiometabolic health, and poorer cognitive and physical function - three aspects of healthy aging essential for longevity and the maintenance of independence in old age. Questions remain, however, about the pathways and mechanisms through which the adverse health consequences of early life adversity arise. Most research on this topic comes from studies with health measured at a single age in adulthood. Such studies cannot explore the dynamic relationships between early life adversity and changes in health across the life course. We will investigate this in longitudinal studies with repeated measures of health in 3 cohorts. Using repeated measures of health will enable us to assess whether some people remain resilient to the health effects of early adversity, whether some people with favourable health profiles at earlier ages experience deterioration in mid-life health, and the potential for reversibility, i.e. an improvement in health during mid-life. The role of adversity (e.g. abusive or dysfunctional relationships) and resources (e.g. social support) experienced in adulthood also remains uncertain. In all 3 cohorts, we will examine whether adversity and resources in adulthood explain or alter the relationship between early adversity and trajectories of health. Risk factors such as smoking and obesity play a role in the generation of health inequalities, and interventions that reduce these risk factors would reduce the adverse health consequences of early life adversity. However, most of this evidence comes from studies with single measurements of smoking, obesity, etc. In all 3 cohorts, we will use repeated measurements of smoking, alcohol use, physical activity, mental health and personality traits, and explore their role in the relationship between early life adversity and later health. Our approach will enable us to identify detrimental or health-promoting behavioural or psychological trajectories. Finally, insufficient attention has been given in the literature to the the biological mechanisms through which early life adversity affects later health. We will estimate the role of two biological processes, DNA methylation and cortisol, in the associations between early life adversity and trajectories of health.