Income, Education, and Inflammation: Differential Associations in a National Probability Sample (The MIDUS Study)
Income, Education, and Inflammation: Differential Associations in a National Probability Sample (The MIDUS Study)
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DOI：
10.1097/psy.0b013e3181cfe4c2
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发表时间：
2010-04-01
影响因子：
3.3
通讯作者：
Herd, Pamela
中科院分区：
文献类型：
--
作者：
Friedman, Elliot M.;Herd, Pamela
目的：检查收入和教育与三种炎症标志物：白细胞介素-6（IL-6）、C反应蛋白（CRP）和纤维蛋白原之间的关联。社会经济地位与健康结果成反比，但人们对社会地位“深入皮肤”影响健康的生物过程知之甚少。方法：横断面分析涉及的参与者（n = 704），从第二波的全国人口为基础的调查中年发展在美国（MIDUS）。研究者以问卷调查及电话访问方式，分别收集税前家庭调整收入及教育程度资料。详细的病史访谈，药物库存，并在夜间门诊期间获得用于评估炎症蛋白的空腹血液样本。结果：在双变量分析中，所有三种炎症蛋白与收入和教育程度呈负相关。然而，多变量回归模型，调整潜在的混乱，表明只有低收入预测炎症蛋白水平较高。此外，将IL-6纳入CRP和纤维蛋白原的回归模型消除了与收入的关联。结论：这些结果表明，收入解释了教育和外周炎症之间的关联。简而言之，高等教育与外周炎症减少有关的原因是因为它降低了低收入状况的风险，这与外周炎症减少直接相关。研究结果还表明，收入与CRP和纤维蛋白原之间的联系是由IL-6介导的。这些观察有助于加深我们对美国社会地位与疾病生物标志物之间关系的理解。
Objective: To examine the associations between income and education and three markers of inflammation: interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen. Socioeconomic status is inversely linked with health outcomes, but the biological processes by which social position "gets under the skin" to affect health are poorly understood. Method: Cross-sectional analyses involved participants (n = 704) from the second wave of the national population-based Survey of Midlife Development in the United States (MIDUS). Data on pretax household-adjusted income and educational attainment were collected by questionnaire and telephone interview, respectively. Detailed medical history interviews, inventories of medication, and fasting blood samples for assessment of inflammatory proteins were obtained during an overnight clinic stay. Results: All three inflammatory proteins were inversely associated with both income and education in bivariate analyses. However, multivariate regression models, adjusting for potential confounds, showed that only low income predicted higher levels of inflammatory proteins. Moreover, inclusion of IL-6 in the regression models for CRP and fibrinogen eliminated the associations with income. Conclusion: These results suggest that income explains the association between education and peripheral inflammation. In short, the reason that higher education is linked to reduced peripheral inflammation is because it reduces the risk for low income status, which is what is directly associated with reduced peripheral inflammation. The findings also suggest that the links between income and both CRP and fibrinogen are mediated by IL-6. These observations help to sharpen our understanding of the relationship between social position and biological markers of illness in the United States.