Early adversity is associated with poor cardiometabolic health, potentially via psychological distress. However, not everyone exposed to adversity develops significant distress. Psychological resilience and positive psychological health despite adversity may protect against unfavorable cardiometabolic outcomes that are otherwise more likely. We examined early adversity, psychological resilience, and cardiometabolic risk among 3,254 adults in the Midlife in the United States Study. Psychological resilience was defined according to both early psychosocial adversity and adult psychological health (characterized by low distress and high wellbeing) at Wave 1 (1994 to 1995). Categorical resilience was derived by cross-classifying adversity (exposed versus unexposed) and psychological health (higher versus lower). We also assessed count of adversities experienced and psychological symptoms as separate variables. Incident cardiometabolic conditions (e.g., heart attack, stroke, and diabetes) were self-reported at Waves 2 (2004 to 2005) and 3 (2013 to 2014). Secondary analyses examined biological cardiometabolic risk using a composite of biomarkers available within a Wave-2 subsample. Logistic and Poisson regressions evaluated associations of resilience with cardiometabolic health across 20 follow-up y, adjusting for relevant covariates. In this initially healthy sample, nonresilient (adversity-exposed, lower psychological health) versus resilient (adversity-exposed, high psychological health) individuals had 43% higher odds of cardiometabolic conditions (95% CI 1.10 to 1.85). Odds of cardiometabolic conditions were similar among resilient versus unexposed, psychologically healthy individuals. More adversity experiences were associated with increased odds, while better psychological health with decreased odds of cardiometabolic conditions, and effects were largely independent. Patterns were similar for objectively assessed cardiometabolic risk. Psychological resilience in midlife may protect against negative cardiometabolic impacts of early adversity.

早期的逆境与心脏代谢健康状况不佳有关，可能是由于心理困扰。然而，并不是每个暴露在逆境中的人都会产生严重的痛苦。尽管有逆境，但心理弹性和积极的心理健康可以防止不利的心脏代谢结果，否则更有可能发生。我们调查了美国中年研究中 3,254 名成年人的早期逆境、心理弹性和心脏代谢风险。心理复原力是根据第一波（1994 年至 1995 年）的早期社会心理逆境和成人心理健康（以低痛苦和高幸福感为特征）定义的。分类弹性是通过对逆境（暴露与未暴露）和心理健康（较高与较低）进行交叉分类得出的。我们还将经历过的逆境和心理症状的数量作为单独的变量进行评估。在第 2 轮（2004 年至 2005 年）和第 3 轮（2013 年至 2014 年）中自我报告了心脏代谢疾病事件（例如，心脏病发作、中风和糖尿病）。二级分析使用 Wave-2 子样本中可用的生物标志物组合检查了生物心脏代谢风险。Logistic 和 Poisson 回归评估了 20 年随访期间弹性与心脏代谢健康的关联，并针对相关协变量进行了调整。在这个最初健康的样本中，非适应力（遭遇逆境，心理健康程度较低）与适应力强（遭遇逆境，心理健康程度高）的人患心脏代谢疾病的几率高 43%（95% CI 1.10 至 1.85）。有弹性与未暴露的心脏代谢状况的几率相似，心理健康的人。更多的逆境经历与增加的几率相关，而更好的心理健康与心脏代谢疾病的几率降低相关，并且效果在很大程度上是独立的。客观评估的心脏代谢风险的模式相似。中年时期的心理复原力可以防止早期逆境对心脏代谢的负面影响。