Associations of socioeconomic position in childhood and young adulthood with cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-Up Study.
Associations of socioeconomic position in childhood and young adulthood with cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-Up Study.
复制标题
儿童期和青年期社会经济地位与心脏代谢危险因素的关联：耶路撒冷围产期家庭随访研究。
DOI：
10.1136/jech-2014-204323
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发表时间：
2017
影响因子：
6.3
通讯作者：
Hochner,H
中科院分区：
文献类型：
--
作者：
Savitsky,B;Manor,O;Friedlander,Y;Burger,A;Lawrence,G;Calderon-Margalit,R;Siscovick,DS;Enquobahrie,DA;Williams,MA;Hochner,H
研究背景生命过程中的几个阶段对心血管疾病的发生发展具有重要意义。本研究旨在评估儿童和成年社会经济地位（SEP）和社会流动性与心脏代谢危险因素（CMRs）的协会later in life. MethodsWe进行了后续检查的1132个后代，年龄32岁，在人口为基础的队列中的所有出生在耶路撒冷从1974年至1976年。SEP由父母的职业和教育程度表示，成年SEP基于32岁时记录的后代的职业和教育程度。采用线性回归模型分析SEP和社会流动性与CMRs的关系。结果儿童职业SEP与体重指数呈负相关（BMI; β =-0.29，p = 0.031），脂肪百分比（脂肪%; β =-0.58，p = 0.005），胰岛素（β = − 0.01，p = 0.031），甘油三酯（β =-0.02，p = 0.024）和低密度脂蛋白胆固醇（LDL-C; β =-1.91，p = 0.015），独立于成年SEP。成年职业SEP与腰臀比呈负相关（WHR; β =-0.01，p = 0.002），与高密度脂蛋白胆固醇（HDL-C; β = 0.87，p = 0.030）呈正相关。在调整吸烟和不活动因素后，结果仍然相似。儿童教育SEP与WHR和LDL-C水平降低相关（p = 0.0002），成人教育SEP与BMI（p = 0.001）、腰围（p = 0.008）、WHR（p = 0.001）和脂肪%（p = 0.0002）呈负相关，与HDL-C呈正相关（p = 0.030）。此外，研究表明，社会流动性（主要是向上）会产生不利的心脏代谢结果。结论儿童和成年期SEP均独立地对CMR产生影响。匹配-不匹配假说可以解释经历社会流动的参与者中CMR升高的原因。确定生命过程中与SEP相关的方面，转化为心血管风险的社会不平等，可能有助于改善健康和减少心血管疾病的差异。
BackgroundSeveral stages in the life course have been identified as important to the development of cardiovascular disease. This study aimed to assess the associations of childhood and adulthood socioeconomic position (SEP) and social mobility with cardiometabolic risk factors (CMRs) later in life.MethodsWe conducted follow-up examinations of 1132 offspring, aged 32, within a population-based cohort of all births in Jerusalem from 1974 to 1976. SEP was indicated by parents’ occupation and education, and adulthood SEP was based on offspring's occupation and education recorded at age 32. Linear regression models were used to investigate the associations of SEP and social mobility with CMRs.ResultsChildhood-occupational SEP was negatively associated with body mass index (BMI; β=−0.29, p=0.031), fat percentage (fat%; β=−0.58, p=0.005), insulin (β=−0.01, p=0.031), triglycerides (β=−0.02, p=0.024) and low-density lipoprotein cholesterol (LDL-C; β=−1.91, p=0.015), independent of adulthood SEP. Adulthood-occupational SEP was negatively associated with waist-to-hip ratio (WHR; β=−0.01, p=0.002), and positively with high-density lipoprotein cholesterol (HDL-C; β=0.87, p=0.030). Results remained similar after adjustment for smoking and inactivity. Childhood-educational SEP was associated with decreased WHR and LDL-C level (p=0.0002), and adulthood-educational SEP was inversely associated with BMI (p=0.001), waist circumference (p=0.008), WHR (p=0.001) and fat% (p=0.0002) and positively associated with HDL-C (p=0.030). Additionally, social mobility (mainly upward) was shown to have adverse cardiometabolic outcomes.ConclusionsBoth childhood and adulthood SEP contribute independently to CMR. The match–mismatch hypothesis may explain the elevated CMRs among participants experiencing social mobility. Identification of life-course SEP-related aspects that translate into social inequality in cardiovascular risk may facilitate efforts for improving health and for reducing disparities in cardiovascular disease.