Early adversity, in the form of abuse, neglect, socioeconomic status and other adverse experiences, is associated with poor physical and mental health outcomes. To understand the biologic mechanisms underlying these associations, studies have evaluated the relationship between early adversity and telomere length, a marker of cellular senescence. Such results have varied in regard to the size and significance of this relationship. Using meta-analytic techniques, we aimed to clarify the relationship between early adversity and telomere length while exploring factors affecting the association, including adversity type, timing and study design. A comprehensive search in July 2016 of PubMed/MEDLINE, PsycINFO and Web of Science identified 2462 studies. Multiple reviewers appraised studies for inclusion or exclusion using a priori criteria; 3.9% met inclusion criteria. Data were extracted into a structured form; the Newcastle-Ottawa Scale assessed study quality, validity and bias. Forty-one studies (N=30 773) met inclusion criteria. Early adversity and telomere length were significantly associated (Cohen's d effect size=-0.35; 95% CI, -0.46 to -0.24; P<0.0001). Sensitivity analyses revealed no outlier effects. Adversity type and timing significantly impacted the association with telomere length (P<0.0001 and P=0.0025, respectively). Subgroup and meta-regression analyses revealed that medication use, medical or psychiatric conditions, case-control vs longitudinal study design, methodological factors, age and smoking significantly affected the relationship. Comprehensive evaluations of adversity demonstrated more extensive telomere length changes. These results suggest that early adversity may have long-lasting physiological consequences contributing to disease risk and biological aging.

中文翻译：

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早期生活逆境和端粒长度：一项荟萃分析。

以虐待，忽视，社会经济地位和其他不良经历的形式出现的早期逆境与不良的身心健康状况有关。为了了解这些关联的生物学机制，研究评估了早期逆境与端粒长度之间的关系，端粒长度是细胞衰老的标志。就这种关系的规模和重要性而言，这种结果有所不同。我们使用荟萃分析技术，旨在阐明早期逆境与端粒长度之间的关系，同时探索影响这种关联的因素，包括逆境类型，时机和研究设计。2016年7月，对PubMed / MEDLINE，PsycINFO和Web of Science进行了全面搜索，确定了2462项研究。多个审阅者使用先验标准评估研究是否包括在内；3。9％符合纳入标准。数据被提取为结构化形式；Newcastle-Ottawa量表评估了研究质量，有效性和偏倚。41项研究（N = 30 773）符合纳入标准。早期逆境和端粒长度显着相关（Cohen's d效应大小= -0.35； 95％CI，-0.46至-0.24； P <0.0001）。敏感性分析显示没有异常影响。逆境类型和时机显着影响与端粒长度的关联（分别为P <0.0001和P = 0.0025）。亚组和荟萃回归分析显示，药物使用，医疗或精神疾病，病例对照与纵向研究设计，方法学因素，年龄和吸烟之间的关系显着影响。逆境的综合评估表明端粒的长度变化更为广泛。