Socioeconomic Differentials in Immune Response
Socioeconomic Differentials in Immune Response
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DOI：
10.1097/ede.0b013e3181bb5302
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发表时间：
2009-11-01
期刊：
影响因子：
5.4
通讯作者：
Aiello, Allison E.
中科院分区：
文献类型：
--
作者：
Dowd, Jennifer Beam;Aiello, Allison E.
背景：较低的社会经济地位（SES）与健康结果密切相关，尽管其机制尚不清楚。人们对免疫系统在造成和维持健康差异方面的作用知之甚少。在这里，我们测试 SES 是否与细胞介导的免疫相关，这是通过宿主将持续性巨细胞病毒 (CMV) 抗体水平保持在静止状态的能力来衡量的。方法：使用删失回归模型来测试教育、收入和种族/族裔与 CMV 抗体反应的横截面关系，使用的是第三次全国健康和营养检查调查 (NHANES III， 1988-1994）。结果：在 CMV 血清阳性受访者中，受教育程度较低、收入较低和非白人种族/民族的人在所有年龄段的 CMV 抗体水平较高。平均而言，年龄每增加一年，CMV 抗体水平就会升高 0.03 个单位（95% 置信区间 = 0.03 至 0.04），而受教育程度每增加一年，抗体水平就会降低 0.05 个单位（0.02 至 0.09）。家庭收入翻倍与抗体水平降低 0.25 个单位（0.11 至 0.39）相关，相当于与年龄相关的 CMV 抗体反应减少 8 年。在控制基线健康状况、吸烟状况和 BMI 后，这些关系仍然很强。 结论：在全国代表性样本中，SES 与细胞介导的免疫的间接标志物相关。 SES 对 CMV 免疫控制的差异可能对生命历程中的健康差异产生根本性影响。
Background: Lower socioeconomic status (SES) is strongly linked to health outcomes, though the mechanisms are poorly understood. Little is known about the role of the immune system in creating and sustaining health disparities. Here we test whether SES is related to cell-mediated immunity, as measured by the host's ability to keep persistent cytomegalovirus (CMV) antibody levels in a quiescent state.Methods: Censored regression models were used to test the cross-sectional relationship of education, income, and race/ethnicity with antibody response to CMV, using a nationally representative sample of 9721 respondents aged 25 years and older in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994).Results: Among CMV-seropositive respondents, those with less education, lower income, and nonwhite race/ethnicity had higher levels of CMV antibodies at all ages. On average, each additional year of age was associated with CMV antibody levels that were 0.03 units higher (95% confidence interval = 0.03 to 0.04), whereas each additional year of education was associated with antibody levels that were 0.05 units lower (0.02 to 0.09). A doubling of family income was associated with antibody levels that were 0.25 units lower (0.11 to 0.39), the equivalent of 8 fewer years of age-related CMV antibody response. These relationships remained strong after controlling for baseline health conditions, smoking status, and BMI.Conclusions: SES is associated with an indirect marker of cell-mediated immunity in a nationally representative sample. SES differences in immune control over CMV may have fundamental implications for health disparities over the life course.