Philipp Töpfer, Ulrike Siewert-Markus, Johanna Klinger-König, Hans J. Grabe, Sylvia Stracke, Marcus Dörr, Henry Völzke, Till Ittermann, Marcello R. P. Markus

• Background Child maltreatment (CM) is linked to obesity in adulthood. However, sex-differences and direct measurements of body fat have previously been insufficiently considered in this context. Objective To assess sex-specific associations of CM with anthropometric markers of overweight/obesity and direct measures of body fat. Participants and setting Analyses were conducted in 4006 adults from a population-based cohort in Northeastern Germany (SHIP-TREND-0). Methods CM was assessed using the Childhood Trauma Questionnaire (CTQ). Obesity-related traits included anthropometric indicators (i.e., height, weight, body mass index [BMI], waist [WC] and hip circumference [HC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), fat mass (FM) and fat-free mass (FFM) derived from bioelectrical impedance analysis (BIA), and subcutaneous (SAT) and visceral adipose tissue (VAT) ascertained using magnetic resonance imaging (MRI). Sex-stratified linear regression models predicting obesity-related traits from total CTQ scores were adjusted for age and education. Exploratory analyses investigated effects of CTQ subscales on obesity-related traits. Results In men, CM was positively associated with WHtR (β = 0.04; p = .030) and VAT (β = 0.02; p = .031) and inversely with body height (β = −0.05; p = .010). In women, CM-exposure was positively associated with body weight (β = 0.07; p = .018), BMI (β = 0.03; p = .013), WC (β = 0.07; p = .005), HC (β = 0.05; p = .046), WHR (β = 0.03; p = .015), WHtR (β = 0.04; p = .006), FM (β = 0.04; p = .006), and SAT (β = 0.06; p = .041). In both sexes, effects were mainly driven by exposure to emotional and physical abuse. Conclusions Results suggest that associations between CM-exposure and obesity-related traits in adulthood are primarily present in women. This may have implications for sex-specific obesity-related cardiometabolic risk after CM.