Life Course Models of Socioeconomic Position and Cardiovascular Risk Factors: 1946 Birth Cohort
Life Course Models of Socioeconomic Position and Cardiovascular Risk Factors: 1946 Birth Cohort
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DOI：
10.1016/j.annepidem.2011.04.005
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发表时间：
2011-08-01
影响因子：
5.6
通讯作者：
Hardy, Rebecca
中科院分区：
文献类型：
--
作者：
Murray, Emily T.;Mishra, Gita D.;Hardy, Rebecca
目得：确定最能描述生命过程社会经济地位（SEP）与心血管（CVD）危险因素之间关系的生命过程模型（即，体重指数[BMI]，收缩压和舒张压，总胆固醇，低密度脂蛋白，高密度脂蛋白，甘油三酯和糖化血红蛋白），并探讨BMI在整个生命过程中作为中介的关系。医学研究理事会全国健康与发展调查被用来比较部分F-测试的简单嵌套的生命过程SEP模型对应的关键期，积累，社会流动性模型与饱和模型。然后，为每个CVD危险因素选择的生命历程模型调整BMI在53岁和终身BMI（年龄4，26，43，和53岁）。结果：在女性中，SEP通常与CVD危险因素的累积方式，而儿童期的关键时期是男性的突出模型。当使用最佳拟合SEP模型时，我们发现在53岁时调整BMI会降低男女所有结局的相关性。进一步调整终身BMI（4，26，43，和53岁）并没有实质性改变大多数协会（除了甘油三酯）。结论：SEP在不同的时间点在整个生命的影响心血管疾病的危险因素不同的男性和女性。Ann Epidemiol 2011;21：589-597.爱思唯尔公司出版
PURPOSE: To identify the life course model that best describes the association between life course socioeconomic position (SEP) and cardiovascular (CVD) risk factors (ie, body mass index [BMI], systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, and glycated hemoglobin) and explore BMI across the life course as mediators of the relationship.METHODS: The Medical Research Council National Survey of Health and Development was used to compare partial F-tests of simpler nested life course SEP models corresponding to critical period, accumulation, and social mobility models with a saturated model. Then, the chosen life course model for each CVD risk factor was adjusted for BMI at age 53 and lifetime BMI (ages 4, 26, 43, and 53 years).RESULTS: Among women, SEP was generally associated with CVD risk factors in a cumulative manner, whereas childhood critical period was the prominent model for men. When the best-fitting SEP models were used, we found that adjustment for BMI at age 53 reduced associations for all outcomes in both genders. Further adjustment for lifetime BMI (4, 26, 43, and 53 years) did not substantially alter most associations (except for triglycerides).CONCLUSIONS: SEP at different points across life influences CVD risk factors differently in men and women. Ann Epidemiol 2011;21:589-597. Published by Elsevier Inc.