Unemployment and inflammatory markers in England, Wales and Scotland, 1998-2012: Meta-analysis of results from 12 studies
Unemployment and inflammatory markers in England, Wales and Scotland, 1998-2012: Meta-analysis of results from 12 studies
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DOI：
10.1016/j.bbi.2017.03.012
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发表时间：
2017-08-01
影响因子：
15.1
通讯作者：
Bartley, Mel
中科院分区：
文献类型：
--
作者：
Hughes, Amanda;Kumari, Meena;Bartley, Mel
导言：对许多受影响的个人来说，失业是心理社会压力的一个重要来源，与发病率和死亡率的增加以及与健康有关的不良行为有关。很少有研究考察失业与全身性炎症之间的关系，而全身性炎症是社会心理压力与健康之间的一种可能的中介，研究结果是混杂的，并取决于具体情况。本研究探讨了失业与c反应蛋白（CRP）和纤维蛋白原（两种全身性炎症标志物）之间的关系。方法：采用多水平建模方法进行随机效应荟萃分析，包括1998年至2012年12项英国全国工作年龄参与者的调查，其中测量了CRP和纤维蛋白原（N = 30,037名经济活跃参与者）。研究了参与者年龄和英国国家的调节作用。结果：失业人群CRP和纤维蛋白原水平高于就业人群；在调整了年龄、性别、教育程度、长期疾病、吸烟和体重指数后，求职者的CRP水平也更有可能（优势比：1.39,p < 0.001）对应于心血管疾病高风险（bb0.3 mg/L）。这些关联不能用心理健康来解释。协会在中年达到顶峰，苏格兰和威尔士比英格兰更强大。结论：我们的研究表明，全身性炎症与社会环境的一个重要但很少被研究的方面有关，因为与受雇的调查参与者相比，失业者的全身性炎症水平更高。修改表明失业和炎症的关联在很大程度上受到环境因素的影响，在威尔士可能特别强烈，需要进一步调查这种关系。(C) 2017作者。Elsevier Inc.出版。
Introduction: Unemployment represents for many affected individuals a substantial source of psychosocial stress, and is linked to both increased risk of morbidity and mortality and adverse health-related behaviours. Few studies have examined the association of unemployment with systemic inflammation, a plausible mediator of the associations of psychosocial stress and health, and results are mixed and context dependent. This study examines the association of unemployment with C-reactive protein (CRP) and fibrinogen, two markers of systemic inflammation.Methods: A random-effects meta-analysis was performed using a multilevel modelling approach, including 12 national UK surveys of working-age participants in which CRP and fibrinogen were measured between 1998 and 2012 (N = 30,037 economically active participants). The moderating impact of participant age and UK country was explored.Results: CRP and fibrinogen were elevated in unemployed compared to employed participants; jobseekers were also more likely (Odds Ratio: 1.39, p < 0.001) to have CRP levels corresponding to high cardiovascular risk (>3 mg/L), after adjustment for age, gender, education, long-term illness, smoking, and body mass index. Associations were not explained by mental health. Associations peaked in middle-age, and were stronger in Scotland and Wales than in England.Conclusions: Our study demonstrates that systemic inflammation is associated with an important but little-studied aspect of the social environment, as it is elevated in unemployed compared to employed survey participants. Modifications suggest the association of unemployment and inflammation is substantially influenced by contextual factors, and may be especially strong in Wales, where further investigation of this relationship is needed. (C) 2017 The Author(s). Published by Elsevier Inc.