Understanding how childhood psychosocial adjustment (CPA) influences later life health outcomes is crucial for developing interventions to mitigate the long-term risk of cardiometabolic diseases (CMDs).

To investigate the association between CPA and incident CMDs in mid-life, and the mediating roles of educational attainment, smoking habits and depression during young adulthood.

A prospective cohort study utilised data from the 1958 National Child Development Study (NCDS; 1958–2013) and the 1970 British Cohort Study (BCS70; 1970–2018), encompassing 22 012 participants assessed for CPA in childhood, who were subsequently evaluated for educational attainment, smoking habits and depression in young adulthood, followed by assessments for CMDs in mid-life. CPA was assessed using the Bristol Social Adjustment Guides in the NCDS and the Rutter Child Behaviour Scale in the BCS70, with higher scores indicating poorer psychosocial adjustment. The primary outcomes were the mid-life incidences of hypertension, diabetes and obesity.

Compared with children in the lowest tertile for CPA scores, those in the middle tertile had an adjusted odds ratio for hypertension of 0.98 (95% CI 0.90–1.06), whereas those in the highest tertile had an odds ratio of 1.17 (95% CI 1.08–1.26). For diabetes, the corresponding odds ratios (95% CI) were 1.15 (0.98–1.35) and 1.39 (1.19–1.62). For obesity, the corresponding odds ratios (95% CI) were 1.08 (1.00–1.16) and 1.18 (1.09–1.27). These associations were partially mediated by educational attainment (2.4–13.9%) and depression during young adulthood (2.5–14.9%).

Poorer CPA is correlated with the development of hypertension, diabetes and obesity in mid-life. Interventions aimed at improving CPA may help in reducing the burden of these diseases in later life.

了解儿童心理社会适应 （CPA） 如何影响以后的生活健康结果，对于制定干预措施以减轻心脏代谢疾病 （CMD） 的长期风险至关重要。

探讨 CPA 与中年事件 CMD 之间的关联，以及受教育程度、吸烟习惯和青年期抑郁的中介作用。

一项前瞻性队列研究利用了 1958 年全国儿童发展研究 （NCDS;1958-2013 年）和 1970 年英国队列研究 （BCS70;1970-2018） 的数据，包括 22 012 名参与者在儿童时期接受了 CPA 评估，随后在青年期评估了教育程度、吸烟习惯和抑郁，然后在中年接受了 CMD 评估。使用 NCDS 中的布里斯托尔社会适应指南和 BCS70 中的 Rutter 儿童行为量表评估 CPA，分数越高表示社会心理适应能力越差。主要结局是高血压、糖尿病和肥胖的中年发病率。

与 CPA 评分最低三分位数的儿童相比，中间三分位数的儿童高血压校正比值比为 0.98 （95% CI 0.90-1.06），而最高三分位数的儿童的比值比为 1.17 （95% CI 1.08-1.26）。对于糖尿病，相应的比值比 （95% CI） 为 1.15 （0.98-1.35） 和 1.39 （1.19-1.62）。对于肥胖，相应的比值比 （95% CI） 为 1.08 （1.00-1.16） 和 1.18 （1.09-1.27）。这些关联部分由受教育程度 （2.4-13.9%） 和青年期抑郁 （2.5-14.9%） 介导。

较差的 CPA 与中年高血压、糖尿病和肥胖症的发展相关。旨在改善 CPA 的干预措施可能有助于减轻这些疾病在以后的生活中的负担。