Novel coronary heart disease risk factors at 60-64 years and life course socioeconomic position: The 1946 British birth cohort
Novel coronary heart disease risk factors at 60-64 years and life course socioeconomic position: The 1946 British birth cohort
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DOI：
10.1016/j.atherosclerosis.2014.11.011
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发表时间：
2015-01-01
期刊：
影响因子：
5.3
通讯作者：
Thomas, Claudia
中科院分区：
文献类型：
--
作者：
Jones, Rebecca;Hardy, Rebecca;Thomas, Claudia
整个生命过程中的社会劣势与冠心病 (CHD) 的较高风险以及已确定的 CHD 危险因素相关，但人们对新的 CHD 危险因素是否表现出相同的模式知之甚少。医学研究委员会国家健康与发展调查用于调查儿童期、成年早期和中年时期的职业社会经济地位与炎症标志物（C 反应蛋白、白细胞介素 6）、内皮功能（Eselectin、组织纤溶酶原激活剂）、脂肪细胞功能（瘦素、脂联素）和胰腺 β 细胞功能（胰岛素原）之间的关联 测量年龄为 60-64 岁。将代表敏感期、风险累积和社会流动性的生命历程模型与饱和模型进行比较，以确定整个生命过程中的社会阶层与这些新的冠心病风险因素之间关系的性质。对于白细胞介素6和瘦素而言，仅儿童期社会经济地位较低与60-64岁时的高风险因素水平相关，而对于C反应蛋白和胰岛素原，儿童期和成年早期社会经济地位较低的累积影响与60-64岁时较高的（不利）风险因素水平相关。没有观察到任何生命阶段的社会经济地位与内皮标记物或脂联素之间的关联。通过调整体重指数以及较小程度的吸烟，C反应蛋白、白细胞介素6、瘦素和胰岛素原的关联性显着降低。总之，早年的社会经济地位是几个新的冠心病危险因素的重要决定因素。体重指数可能是这些关系的重要调节因素。 (C) 2014 年作者。由 Elsevier Ireland Ltd 出版。这是一篇 CC 许可下的开放获取文章。
Social disadvantage across the life course is associated with a greater risk of coronary heart disease (CHD) and with established CHD risk factors, but less is known about whether novel CHD risk factors show the same patterns. The Medical Research Council National Survey of Health and Development was used to investigate associations between occupational socioeconomic position during childhood, early adulthood and middle age and markers of inflammation (C-reactive protein, interleukin-6), endothelial function (Eselectin, tissue-plasminogen activator), adipocyte function (leptin, adiponectin) and pancreatic beta cell function (proinsulin) measured at 60-64 years. Life course models representing sensitive periods, accumulation of risk and social mobility were compared with a saturated model to ascertain the nature of the relationship between social class across the life course and each of these novel CHD risk factors. For interleukin-6 and leptin, low childhood socioeconomic position alone was associated with high risk factor levels at 60-64 years, while for C-reactive protein and proinsulin, cumulative effects of low socioeconomic position in both childhood and early adulthood were associated with higher (adverse) risk factor levels at 60-64 years. No associations were observed between socioeconomic position at any life period with either endothelial marker or adiponectin. Associations for C-reactive protein, interleukin-6, leptin and proinsulin were reduced considerably by adjustment for body mass index and, to a lesser extent, cigarette smoking. In conclusion, socioeconomic position in early life is an important determinant of several novel CHD risk factors. Body mass index may be an important mediator of these relationships. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC license.