title: Socioeconomic status is positively associated with measures of adiposity and insulin resistance, but inversely associated with dyslipidaemia in Colombian children.
abstract: BACKGROUND
  Low socioeconomic status (SES) has been associated with higher risk of cardiometabolic diseases in developed societies, but investigation of SES and cardiometabolic risk in children in less economically developed populations is sparse. We aimed to examine associations among SES and cardiometabolic risk factors in Colombian children.
  
  
  METHODS
  We used data from a population-based study of 1282 children aged 6-10 years from Bucaramanga, Colombia. SES was classified according to household wealth, living conditions and access to public utilities. Anthropometric and biochemical parameters were measured at a clinic visit. Cardiometabolic risk factors were analysed continuously using linear regression and as binary outcomes-according to established paediatric cut points-using logistic regression to calculate OR and 95% CIs.
  
  
  RESULTS
  Mean age of the children was 8.4 (SD 1.4) and 51.1% of the sample were boys. Odds of overweight/obesity, abdominal obesity and insulin resistance were greater among higher SES. Compared with the lowest SES stratum, children in the highest SES had higher odds of overweight/obesity (OR=3.25, 95% CI 1.89 to 5.57), abdominal obesity (OR=2.74, 95% CI 1.41 to 5.31) and insulin resistance (OR=2.60, 95% CI 1.81 to 3.71). In contrast, children in the highest SES had lower odds of hypertriglyceridaemia (triglycerides ≥90th centile; OR=0.28, 95% CI 0.14 to 0.54) and low (≤10th centile) high-density lipoprotein (HDL) cholesterol (OR=0.35, 95% CI 0.15 to 0.78).
  
  
  CONCLUSIONS
  In Colombian children, SES is directly associated with obesity and insulin resistance, but inversely associated with dyslipidaemia (hypertriglyceridaemia and low HDL cholesterol). Our findings highlight the need to analyse cardiometabolic risk factors separately in children and to carefully consider a population's level of economic development when studying their social determinants of cardiometabolic disease.
authors.affiliation: Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Adriana
authors.initials: A
authors.lastname: Buitrago-Lopez
authors.affiliation: Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Edith H
authors.initials: EH
authors.lastname: van den Hooven
authors.affiliation: Department of Medicine, University of Alberta, Li Ka Shing Centre for Heath Research Innovation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Rueda-Clausen
authors.affiliation: Division of Research, Fundacion Cardiovascular de Colombia, Floridablanca, Santander, Colombia.
authors.forename: Norma
authors.initials: N
authors.lastname: Serrano
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota DC, Colombia.
authors.forename: Alvaro J
authors.initials: AJ
authors.lastname: Ruiz
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pereira
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA.
authors.forename: Noel T
authors.initials: NT
authors.lastname: Mueller
mesh_terms: D050154:Adiposity; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D050171:Dyslipidemias / Q000191:economics / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007407:Interviews as Topic; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D056128:Obesity, Abdominal / Q000191:economics / Q000453:epidemiology; D063766:Pediatric Obesity / Q000191:economics / Q000453:epidemiology*; D010808:Physical Examination; D065840:Protective Factors; D012307:Risk Factors; D012923:Social Class; D064890:Social Determinants of Health / Q000191:economics*
keywords: CHILD HEALTH; DEVELOPING COUNTR; Epidemiology of cardiovascular disease; Epidemiology of diabetes; NUTRITION