When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood
When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood
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DOI：
10.1136/jech.53.12.757
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发表时间：
1999-12-01
影响因子：
6.3
通讯作者：
Marmot, MG
中科院分区：
文献类型：
--
作者：
Brunner, E;Shipley, MJ;Marmot, MG
研究目的--比较儿童和成人的社会经济地位与成年后测量的心血管危险因素的关系。设计-横断面调查，使用不平等的相对指数方法比较不同人生阶段的社会经济差异。背景-英国白厅II纵向研究，研究基线为1985-88年，受雇于伦敦公务员办公室的男性和女性。参与者-4774名男性和2206名女性，出生于1930-53年。主要结果-成人职业职位(就业级别)与当前吸烟和休闲时间缺乏体力活动、腰围/身高以及代谢风险因素、甘油三酯、高密度脂蛋白和代谢风险因素呈负相关(高地位-低风险)后负荷葡萄糖和纤维蛋白原。这些变量与童年社会经济地位(父亲的登记处总社会阶层)的相关性较弱或不存在，女性中的吸烟除外。男女儿童的社会地位与成年体重有关，女性则与当前吸烟、腰围/身高、高密度脂蛋白胆固醇和纤维蛋白原有关。身高是衡量健康资本或体质的指标，与父亲的社会阶层联系较弱，而与自己的就业级别联系较强。儿童时期的劣势(父亲级别低)和男性低地位文员职业的结合尤其与成年后较高的身体质量指数有关(交互作用检验p
Study objectives-To compare associations of childhood and adult socioeconomic position with cardiovascular risk factors measured in adulthood. To estimate the effects of adult socioeconomic position after adjustment for childhood circumstances.Design-Cross sectional survey, using the relative index of inequality method to compare socioeconomic differences at different life stages.Setting-The Whitehall II longitudinal study of men and women employed in London offices of the Civil Service at study baseline in 1985-88.Participants-4774 men and 2206 women born in the period 1930-53 who were administered questions on early socioeconomic circumstances.Main results-Adult occupational position (employment grade) was inversely associated (high status-low risk) with current smoking and leisure time physical inactivity, with waist/height, and with metabolic risk factors HDL cholesterol, triglycerides, post-load glucose and fibrinogen. Associations of these variables with childhood socioeconomic position (father's Registrar General Social Class) were weaker or absent, with the exception of smoking in women. Childhood social position was associated with adult weight in both sexes and with current smoking, waist/height, HDL cholesterol and fibrinogen in women. Height, a measure of health capital or constitution, was weakly linked with father's social class and more strongly linked with Own employment grade. The combination of childhood disadvantage (low father's class) together with a low status clerical occupation in men was particularly associated with higher body mass index as an adult (interaction test p