title: The role of low grade inflammation as measured by C-reactive protein levels in the explanation of socioeconomic differences in carotid atherosclerosis.
abstract: BACKGROUND
  The role of inflammation as part of the explanation of socioeconomic differences in carotid atherosclerosis has not been specifically investigated.
  
  
  RESULTS
  The associations between socioeconomic position (SEP), C-reactive protein (CRP), and preclinical carotid atherosclerosis were investigated in a general population sample of 3921 middle-aged Swedish men and women. Common carotid intima-media thickness (IMT) and presence of carotid plaque (focal IMT > 1.2 mm) were determined by B-mode ultrasound. The results showed that low SEP was associated with increased levels of CRP, independently of established risk factors. Furthermore, common carotid IMT increased with increasing CRP-levels. Presence of carotid plaque increased with increasing CRP-levels in men, but not in women. While the socioeconomic differences in carotid IMT were weak, there were associations between low educational level and carotid plaque prevalence with an age- and sex-adjusted odds ratio (OR) of 1.39 (95% CI: 1.21, 1.59). A similar association was seen for having a manual occupation, OR = 1.23 (95% CI: 1.07, 1.42). The age- and sex-adjusted absolute differences in carotid plaque prevalence were 9% with regard to educational level and 7% with regard to occupational status. Adjustment for CRP caused only a minor attenuation of the association between SEP and carotid atherosclerosis.
  
  
  CONCLUSIONS
  The association between SEP and carotid atherosclerosis as measured by carotid IMT and carotid plaque could only to a minor extent be referred to differences in low grade inflammation as measured by CRP.
authors.affiliation: Department of Health Sciences, Lund University, Malmö, Sweden. maria.rosvall@smi.mas.lu.se
authors.forename: M
authors.initials: M
authors.lastname: Rosvall
authors.forename: G
authors.initials: G
authors.lastname: Engström
authors.forename: L
authors.initials: L
authors.lastname: Janzon
authors.forename: G
authors.initials: G
authors.lastname: Berglund
authors.forename: B
authors.initials: B
authors.lastname: Hedblad
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012923:Social Class; D013548:Sweden / Q000453:epidemiology; D014463:Ultrasonography
chemical_list: D002097:C-Reactive Protein