Childhood misfortunes and metabolic syndrome in old age: European prospective cohort study.

BACKGROUND AND AIMS: The link between childhood misfortunes and the risk and trajectories of metabolic syndrome (MetS) in older age remains unclear. The study examined (1) whether childhood misfortunes are associated with self-reported MetS and its trajectories in older age, and (2) whether life course socioeconomic conditions and unhealthy behaviours attenuate these associations. METHODS AND RESULTS: Data from 39'251 respondents aged 50+ years, collected between 2004 and 2018 (Survey of Health, Ageing and Retirement in Europe - SHARE) were analysed using logistic and multinomial regressions. MetS was defined as obesity plus hypertension, high cholesterol or diabetes. Childhood socioeconomic conditions, adverse experiences, and poor health were treated as distinct exposures. Life course socioeconomic conditions included education, occupation and financial strain. Unhealthy behaviours included smoking, alcohol consumption, physical inactivity, and poor diet. Disadvantaged childhood socioeconomic conditions were associated with higher MetS risk, partially attenuated by life course socioeconomic conditions but not by unhealthy behaviours. Four MetS trajectories were observed: "never MetS" (81%), "persistent MetS" (8%), "developed MetS" (6%) and "lost MetS" (4%). Disadvantaged childhood socioeconomic conditions, not childhood adverse experiences, increased the risk of each trajectory, partially reduced by adjustment for life course socioeconomic conditions but unaffected by behaviours. Poor childhood health increased the risk of "persistent MetS", with no attenuation by life course conditions or behaviours. CONCLUSIONS: Childhood misfortune predicts elevated MetS risk and trajectory patterns in later life. Early-life misfortune warrants clinical consideration in metabolic risk assessment, as its effects may not be visible through current lifestyle or socioeconomic indicators, pending further research.