Psychiatry Res. 2026 Jun 16;364:117297. doi: 10.1016/j.psychres.2026.117297. Online ahead of print.
ABSTRACT
AIMS: To examine whether distinct life-course patterns of psychological trauma are associated with incident cardiovascular disease (CVD) among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) in early stages of the cardiovascular-kidney-metabolic (CKM) spectrum.
MATERIALS AND METHODS: Prospective cohort of 34,815 UK Biobank participants with MASLD and without baseline CVD (CKM stages 0-3). Latent class analysis identified life-course psycho-trauma patterns from measures of adulthood psychological symptoms, adulthood stressful life events, and childhood adverse experiences. Incident CVD (coronary heart disease, stroke, atrial fibrillation, heart failure, peripheral arterial disease, and cardiovascular death) was ascertained via linked health records. Fine-Gray competing-risk models estimated subdistribution hazard ratios (sHRs) for CVD across trauma classes. Restricted cubic spline analyses evaluated the dose-response relationship between a cumulative psycho-trauma score and CVD risk. Median follow-up was 13.9 years.
RESULTS: Three classes emerged: Asymptomatic; Life-course Psychopathology (high adulthood symptoms plus stressful events and childhood adversities); and Childhood Adversity (predominantly childhood exposures). Over follow-up, 6285 incident CVD events occurred. Compared with the Asymptomatic class, the Life-course Psychopathology class had sHR 1.298 (95% CI 1.142-1.475) and the Childhood Adversity class had sHR 1.175 (95% CI 1.087-1.271). The cumulative trauma score showed a positive, approximately linear association with CVD risk.
CONCLUSIONS: Distinct life-course psychological trauma patterns (i.e. notably adulthood psychopathology and childhood adversity) are independently associated with higher CVD risk in MASLD patients at early CKM stages. Incorporating trauma-informed assessment into cardiometabolic care may improve risk stratification and prevention.
PMID:42341356 | DOI:10.1016/j.psychres.2026.117297