Life-course origins of social inequalities in metabolic risk in the population of a developing country.
In countries that have been industrialized for a long time, but not always elsewhere, low socioeconomic position (SEP) is associated with ischemic heart disease in men. The authors hypothesized that socioeconomic development could, via pubertal sex steroids, promote an atherogenic lipid profile and body shape in men but not in women. Therefore, they examined the associations of SEP with ischemic heart disease risk in a developing-country population. The authors used multivariable regression to examine the associations of SEP with the metabolic syndrome and its components in 9,746 Chinese adults aged >/=50 years from the Guangzhou Biobank Cohort Study, phase 2, recruited in 2005-2006. After adjustment for age, smoking, alcohol use, and physical activity, high SEP at each of three life stages, proxied by parental possesions in childhood, education, and longest held-occupation, was inversely associated with the metabolic syndrome in women but not in men. Higher SEP in men was associated with lower pulse pressure and fasting plasma glucose level but also with greater waist circumference and a lower high density lipoprotein cholesterol level. With socioeconomic development, diet-related hormonal changes at puberty may outweigh the usual protective effect of social advantage in men, with corresponding implications for boys currently undergoing the nutrition transition in the developing world.
Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
C M
CM
Schooling
C Q
CQ
Jiang
T H
TH
Lam
W S
WS
Zhang
K K
KK
Cheng
G M
GM
Leung
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D016001:Confidence Intervals; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology; D009790:Occupations; D016017:Odds Ratio; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D049629:Waist-Hip Ratio
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides