Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V).
Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V).
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DOI：
10.1136/bmjopen-2016-014276
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发表时间：
2017-12-28
期刊：
影响因子：
2.9
通讯作者：
Kim J
中科院分区：
文献类型：
--
作者：
Chung W;Lim SJ;Lee S;Kim R;Kim J
通过考虑自变量的相互作用效应项及其主效应项，确定发达国家教育和收入与肥胖之间的性别相关性。一项横断面研究。教育和收入水平被选为社会经济地位指标。社会人口统计学，生活方式和医疗条件被用作多变量逻辑回归模型的协变量。调整后的OR和预测的肥胖概率进行计算和调整，为一个复杂的调查设计。数据来自第五次韩国国家健康和营养检查调查（2010-2012年）。样本包括7337名男性和9908名女性参与者，年龄≥19岁。根据亚洲人指南，肥胖定义为体重指数≥25。在模型中，没有相互作用的独立变量，教育与肥胖显着相关的男性和女性，但收入是显着的女性。然而，在具有相互作用效应的模型中，教育仅在女性中显着，但收入仅在男性中显着。收入和教育之间的相互作用在男性中很显著，但在女性中不显著。在两种类型的模型之间，以及男性和女性之间，受教育和收入水平影响的肥胖预测概率最高的参与者有所不同。使用模型与相互作用效应项进行的预测表明，对于所有男性来说，最高水平的正规教育与肥胖概率增加26%有关。在发达国家，众所周知的社会经济地位和肥胖之间的负相关可能是无效的，当相互作用的影响。忽视这些影响及其性别差异可能会导致错误的目标人群，以减少肥胖患病率及其由此产生的社会经济梯度。
To identify gender-specific associations between education and income in relation to obesity in developed countries by considering both the interaction-effect terms of the independent variables and their main-effect terms. A cross-sectional study. Education and income levels were chosen as socioeconomic status indicators. Sociodemographics, lifestyles and medical conditions were used as covariates in multivariable logistic regression models. Adjusted ORs and predicted probabilities of being obese were computed and adjusted for a complex survey design. Data were obtained from the Fifth Korea National Health and Nutrition Examination Survey (2010–2012). The sample included 7337 male and 9908 female participants aged ≥19 years. Obesity was defined as body mass index of ≥25, according to a guideline for Asians. In models with no interaction-effect terms of independent variables, education was significantly associated with obesity in both men and women, but income was significant only in women. However, in models with the interaction-effect terms, education was significant only in women, but income was significant only in men. The interaction effect between income and education was significant in men but not in women. Participants having the highest predicted probability of being obese over educational and income levels differed between the two types of models, and between men and women. A prediction using the models with the interaction-effect terms demonstrated that for all men, the highest level of formal education was associated with an increase in their probability of being obese by as much as 26%. The well-known, negative association between socioeconomic status and obesity in developed countries may not be valid when interaction effects are included. Ignoring these effects and their gender differences may result in the targeting of wrong populations for reducing obesity prevalence and its resultant socioeconomic gradients.
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