Association of Adverse Childhood Experiences and Metabolic Syndrome: A Systematic Review and Meta‐Analysis

ABSTRACT Background The association between adverse childhood experiences (ACEs) and metabolic syndrome (MetS) across life course and its components (abdominal obesity, elevated blood pressure, dyslipidemia, and hyperglycemia) is poorly understood. Methods Three databases were screened for studies published January 2000–February 2024 that examined the association between ACE and MetS. Relevant data, including authors, country, study type, participants, types, and number of ACE and MetS and its components, were extracted. Mantel–Haenszel random‐effects models were used to meta‐analyze the association of ACE exposure and MetS and its individual components. Results A total of 16 papers (14 adult, 2 adolescent samples) met inclusion criteria, and 10 were eligible for meta‐analysis. There was a significant association between exposure of ≥ 1 ACE and MetS (odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.18–1.29, I 2 = 82.2%, p < 0.001). Those with ≥ 3 ACEs vs. none had higher odds of MetS (OR = 1.43, 95% CI 1.32–1.55, I 2 = 63.1%, p = 0.019). Associations with ≥ 1 ACE were shown for hyperglycemia (OR = 1.27, 95% CI 1.20–1.33, I 2 = 88.1%, p < 0.001) and elevated blood pressure (OR 1.16, 95% CI 1.07–1.26, I 2 = 28.7%, p = 0.246). There were limited studies that examined the association between ACE and dyslipidemia and abdominal obesity. Some studies showed a stronger association of ACE and MetS among race/ethnic minorities compared with non‐Hispanic White individuals. Conclusions Results show a dose–response relationship between ACE and MetS. These findings can inform the development of targeted interventions and policies to mitigate MetS risk among individuals with ACE exposure, particularly those from race/ethnic minority populations who may be at heightened risk.