title: Educational level and chronic inflammation in the elderly--the role of obesity: results from the population-based CARLA study.
abstract: This study aimed to assess the mediating role of anthropometric parameters in the relation of education and inflammation in the elderly. Cross-sectional data from the population-based CARdio-vascular Disease, Living and Ageing in Halle study were used after excluding subjects with a plasma level of high-sensitive C-reactive protein (hsCRP) above 10 mg L(-1) (916 men/760 women remaining). Education was categorized in accordance with International Standard Classification of Education. As inflammation parameters, the soluble tumour necrosis factor type 1 (sTNF-R1), hsCRP and interleukin 6 (IL-6) were taken into account. Anthropometric parameters were the body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHeR). We used covariate adjusted mixed models to assess associations. Effect measures were the natural indirect effect (NIE), controlled direct effect and total effect (TE). Education was associated with sTNF-R1, hsCRP and IL-6 in men, and sTNF-R1 and hsCRP in women. Anthropometric parameters correlated with all inflammation parameters after covariate adjustment. BMI and WHeR were strong mediators of educational differences in sTNF-R1 (percentage of NIE of TE: 28% in men; 33% in women) and hsCRP (percentage of NIE of TE: 35% in men; 52% in women), while WHR was the weakest mediator. General obesity mediates roughly one-third of the association of education with chronic inflammation in the elderly.
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: D
authors.identifier: http://orcid.org/0000-0001-8920-2853
authors.initials: D
authors.lastname: Medenwald
authors.affiliation: Department of Internal Medicine III, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Loppnow
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kluttig
authors.affiliation: Department of Internal Medicine III, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Nuding
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany.
authors.forename: K H
authors.initials: KH
authors.lastname: Greiser
authors.affiliation: Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Thiery
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Tiller
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Herzog
authors.affiliation: Department of Internal Medicine III, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Werdan
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Haerting
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001827:Body Height; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012737:Sex Factors; D012923:Social Class; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers
keywords: Education; inflammation; mediation; obesity