Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study
Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study
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DOI：
10.1007/s001250050830
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发表时间：
1997-11-01
期刊：
影响因子：
8.2
通讯作者：
Alberti, KGMM
中科院分区：
文献类型：
--
作者：
Brunner, EJ;Marmot, MG;Alberti, KGMM
本报告描述了白厅II研究第3期检查中向心性肥胖和代谢综合征的社会分布，并评估了健康相关行为对其分布的贡献。利用1991-1993年从4978名男性和2035名女性（年龄39-63岁）中收集的数据进行横断面分析，这些人完成了口服葡萄糖耐量试验。在代谢综合征的患病率方面存在着一个逆社会梯度。最低与最高就业级别相比，患有代谢综合征的比值比（95%置信区间）为：男性2.2（1.6-2.9），女性2.8（1.6-4.8）。最低年级与最高年级相比，腰臀比在以下变量中占据前五分位的比值比为：男性2.2（1.8-2.8），妇女1.6（1.1-2.4）;负荷后血糖：男性1.4（1.1-1.8），女性1.8（1.2-2.6）;甘油三酯：男性1.6（1.2-2.0），女性2.2（1.5-3.3）;纤维蛋白原：男性1.7（1.4-2.3），女性1.9（1.2-2.8）。目前的吸烟状况、饮酒量和运动水平对社会经济地位和代谢综合征患病率之间的负相关性有很小的贡献（男性11%，女性9%）。总之，代谢综合征的中心性肥胖成分和血浆纤维蛋白原与社会经济地位呈强负相关。我们的研究结果表明，代谢综合征可能有助于冠状动脉风险的社会不平等的生物学解释。健康相关行为似乎对代谢综合征患病率的社会模式影响不大。
This report describes the social distribution of central obesity and the metabolic syndrome at the Whitehall II study phase 3 examination, and assesses the contribution of health related behaviours to their distribution. Cross-sectional analyses were conducted utilising data collected in 1991-1993 from 4978 men and 2035 women aged 39-63 years who completed an oral glucose tolerance test. There was an inverse social gradient in prevalence of the metabolic syndrome. The odds ratio (95 % confidence interval) for having the metabolic syndrome comparing lowest with highest employment grade was: men 2.2 (1.6-2.9), women 2.8 (1.6-4.8). Odds ratios for occupying the top quintile of the following variables, comparing lowest with highest grade, were, for waist-hip ratio: men 2.2 (1.8-2.8), women 1.6 (1.1-2.4); postload glucose: men 1.4 (1.1-1.8), women 1.8 (1.2-2.6); triglycerides: men 1.6 (1.2-2.0), women 2.2 (1.5-3.3); fibrinogen: men 1.7 (1.4-2.3), women 1.9 (1.2-2.8). Current smoking status, alcohol consumption and exercise level made a small contribution (men 11%, women 9%) to the inverse association between socioeconomic status and metabolic syndrome prevalence. In conclusion, central obesity components of the metabolic syndrome and plasma fibrinogen are strongly and inversely associated with socioeconomic status. Our findings suggest the metabolic syndrome may contribute to the biological explanation of social inequalities in coronary risk. Health related behaviours appear to account for little of the social patterning of metabolic syndrome prevalence.