Socioeconomic mediators of the effect of resilience on cardiometabolic biomarkers in the UK Biobank

Background. Exposure to childhood adversity is linked to negative outcomes later in life, including cardiometabolic diseases. Resilient coping in the face of childhood adversity may buffer the deleterious impact of childhood adversity on cardiometabolic biomarkers. However, further research is needed to shed light on factors mediating the effect of resilience on cardiometabolic health. Objective. To investigate the factors that contribute to resilience in the UK Biobank, a large, heterogenous, population-based cohort study. To investigate socioeconomic mediators of the effect of resilience on metabolic health outcomes. Methods. A resilience metric was derived as residuals from multi-linear regression of subjective wellbeing on child adversity. Structural equation models were fitted to the data with resilience as independent variable, metabolic outcomes as dependent variables and socioeconomic variables as mediators. Results. Resilience was associated with higher household income, lower deprivation, lower glycated haemoglobin and lower LDL-to-HDL cholesterol ratio. The effect of resilience on glycated haemoglobin and BMI were mediated by socioeconomic variables. The effect of resilience on LDL-to-HDL cholesterol ratio was mediated by household income, but not by deprivation. Conclusions. Resilience was found to be associated with higher household income, lower Townsend deprivation index, lower glycated haemoglobin and lower cholesterol levels. The effect of resilience on cardiometabolic biomarkers was mediated by socioeconomic indicators including household income and deprivation.