Mental Health in Early Childhood and Changes in Cardiometabolic Dysregulation by Pre-Adolescence.

Objective Poor mental health in childhood is associated with a greater risk of cardiometabolic disease in adulthood, but less is known about when these associations begin to emerge. This study tests whether poor mental health (indexed by emotional and behavioral problems) in early childhood predicts increases in cardiometabolic dysregulation over 4 years of follow-up. Methods Data are from 4,327 participants in the Generation R Study. Problem behaviors were reported by mothers using the Child Behavior Checklist at age 6 years. Repeated measurements of 6 cardiometabolic parameters were collected at ages 6 and 10 years: high-density lipoprotein cholesterol (HDL-C), non-HDL-C, systolic and diastolic blood pressure, C-reactive protein, and body mass index. Standardized measures were used to create continuous cardiometabolic dysregulation scores at ages 6 and 10 years. Change in dysregulation was defined as the difference in dysregulation scores over time. Cross-sectional and prospective associations were tested using linear regression, sequentially adjusting for relevant confounders. Additional analyses examined whether prospective relationships were robust to adjustment for baseline levels of dysregulation. Results There was no association between child problem behaviors and cardiometabolic dysregulation at age 6 years. However, higher levels of problem behaviors predicted increases in cardiometabolic dysregulation (s=0.12, 95% Confidence Interval (CI)=0.00, 0.23) from age 6 to 10 years. Conclusions Worse child mental health may be associated with increases in cardiometabolic dysregulation by pre-adolescence. To our knowledge, this is the first study to demonstrate that adverse physiologic effects of psychological distress identified in adult populations may be observed as early as childhood.