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@ARTICLE{Tpfer:285261,
      author       = {Töpfer, Philipp and Klinger-König, Johanna and
                      Siewert-Markus, Ulrike and Schipf, Sabine and Fischer, Beate
                      and Sedlmeier, Anja M and Hebestreit, Antje and Ahrens,
                      Wolfgang and Berger, Klaus and Brenner, Hermann and Do,
                      Stefanie and Heise, Jana-Kristin and Jaskulski, Stefanie and
                      Karch, André and Keil, Thomas and Klett-Tammen, Carolina
                      and Leitzmann, Michael F and Peters, Annette and Schmidt,
                      Börge and Schulze, Matthias B and Willich, Stefan N and
                      Dörr, Marcus and Völzke, Henry and Markus, Marcello R P
                      and Stracke, Sylvia and Grabe, Hans J and Ittermann, Till},
      title        = {{S}ex-dependent associations of childhood maltreatment with
                      obesity-related traits: results from the {G}erman {N}ational
                      {C}ohort ({NAKO}).},
      journal      = {International journal of obesity},
      volume       = {50},
      number       = {2},
      issn         = {0307-0565},
      address      = {Avenel, NJ},
      publisher    = {Nature Publ. Group},
      reportid     = {DZNE-2026-00203},
      pages        = {329 - 337},
      year         = {2026},
      abstract     = {The relationship between childhood maltreatment (CM) and
                      obesity is nuanced, and recent evidence suggests stronger
                      associations between CM and obesity-related traits in
                      females compared to males. This study aims to validate and
                      extend these findings in a large sample from the German
                      National Cohort (NAKO).The NAKO is a population-based cohort
                      study including 204,744 adults. For the present analyses,
                      151,143 individuals (74,596 female) were included. CM was
                      assessed using the Childhood Trauma Screener (CTS). From the
                      CTS, an overall severity score (CTS sum score), a cumulative
                      CM score (number of CM subtypes with at least moderate
                      severity), and five CTS subtypes were considered as
                      exposures. Obesity-related traits included anthropometric
                      (height, weight, body mass index [BMI], waist circumference
                      [WC]) and body fat markers (relative fat mass [rFM],
                      subcutaneous [SAT], visceral adipose tissue [VAT]).
                      Sex-stratified linear and logistic regression models were
                      adjusted for age, education, and examination center to
                      associate CTS-based scores with obesity-related
                      traits.Associations of the CTS sum score with weight, BMI,
                      WC, rFM, and SAT were stronger in females compared to males,
                      while similar associations were observed for VAT. In both
                      sexes, most obesity-related traits exhibited dose-response
                      relationships with increasing numbers of CM subtypes.
                      Compared to unexposed females, females with exposure to ≥3
                      CM subtypes had a higher risk for obesity (i.e., BMI ≥ 30
                      kg/m2; OR = 1.56; $95\%$ CI: 1.43, 1.71) and high WC (i.e.,
                      WC ≥ 88 cm; OR = 1.39; $95\%$ CI: 1.29, 1.50). In males,
                      exposure to ≥3 CM subtypes was also associated with
                      increased obesity risk (OR = 1.51; $95\%$ CI: 1.32, 1.72)
                      and high WC (i.e., WC ≥ 102 cm; OR = 1.31; $95\%$ CI:
                      1.18, 1.44). Physical and emotional abuse exhibited the
                      strongest average associations and were associated with the
                      most outcomes.Associations of CM exposure with adult
                      anthropometric and body fat markers are stronger in females
                      compared to males.},
      keywords     = {Humans / Male / Female / Germany: epidemiology / Adult /
                      Obesity: epidemiology / Middle Aged / Cohort Studies / Sex
                      Factors / Body Mass Index / Child / Risk Factors},
      cin          = {AG Grabe},
      ddc          = {610},
      cid          = {I:(DE-2719)5000001},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41652183},
      pmc          = {pmc:PMC12913021},
      doi          = {10.1038/s41366-025-01914-2},
      url          = {https://pub.dzne.de/record/285261},
}