Exposure to abuse and changes in cardiometabolic risk profiles over 3 years in young South African women

Abstract

Abstract Background: South African women experience high rates of abuse and cardiometabolic diseases (CMD), but research on their relationship is less investigated. This study examined the associations of exposure to abuse in childhood and adulthood with CMD risk factors [body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), HbA1c] over three years among baseline rape-exposed and rape-unexposed women aged 18-40 years. Methods: In longitudinal analyses of baseline-rape-exposed and rape-unexposed women from the Rape Impact Cohort Evaluation (RICE) study; the associations of CMD risk factors with self-reported exposures to childhood abuse (CA) (any, sexual, physical, emotional CA and parental neglect), intimate partner violence (IPV) (any, sexual, physical, emotional and economic IPV), non-partner sexual violence (NPSV) were explored using linear mixed-effects models, with the inclusion of the interaction term, ‘abuse/trauma*rape-exposed’. Results: CMD data were collected at baseline (N=1617; mean age 25.3 years), 12 (N=1178), 24 (N=925) and 36 months (N=571). Any CA and greater frequency of physical CA were associated with rising BMI over 3 years of follow-up, with no evidence of an interaction effect of baseline rape exposure (p≥0.057 for all interaction tests). Exposure to more than one episode of NPSV was associated with lower WC and BMI, but not other CMD risk variables. Exposures to IPV were not associated with changes in the variables investigated. There was no evidence of a significant interaction effect between baseline rape exposure and lifetime abuse exposure for any of the associations examined (p≥0.095 for all interaction tests), except for WC-sexual CA (p=0.010 for interaction test). Conclusions: This prospective analysis demonstrated that CA experiences were associated with increased BMI levels over 3 years of follow-up in young South African women. Further research over a longer period is required to clearly delineate the effect of rape exposure on CMDs.