Santos Ana C, Ebrahim Shah, Barros Henrique
Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
BMC Public Health. 2008 Feb 18;8:62. doi: 10.1186/1471-2458-8-62.
Studies that addressed social and economic determinants of cardiovascular diseases, consistently showed an increase prevalence of the individual features of metabolic syndrome in the lower socio-economic strata. Thus, this study aimed to evaluate the association between social class and metabolic syndrome in a sample of urban middle-aged and old Portuguese adults.
We evaluated 1962 subjects (1207 women and 755 men) aged 40 or more years. Marital status, education, occupation, menarche age and height distribution were used as socioeconomic indicators. Metabolic syndrome was defined according to the ATP III, by the presence of at least three of the following characteristics: waist circumference > 102 cm in men and > 88 cm in women; triglycerides > or = 150 mg/dl; HDL cholesterol < 40 mg/dl in men and < 50 mg/dl in women; blood pressure > or = 130/85 mm Hg; and fasting glucose > or = 110 mg/dl. Proportions were compared using the chi square test or Fisher's exact test. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using unconditional logistic regression to estimate the magnitude of the associations.
Metabolic syndrome was significantly more frequent in females (24.9 vs. 17.4, p < 0.001). In females, the odds favoring metabolic syndrome significantly increased with age and in unfavorable social class as described by occupation, and decreased with education level. In males, metabolic syndrome was significantly more frequent in the 60-69 years age class (OR = 1.82; 95%CI: 1.02-3.26) when compared to those in the 40-49 years age class. Concerning other socioeconomic indicators no significant associations were found.
This study showed that gender influenced the association of socio-economic status indicators with metabolic syndrome. Females in lower social classes, as defined by education and occupational classification, more frequently presented metabolic syndrome, no such association was found in males.
针对心血管疾病社会和经济决定因素的研究一致表明，代谢综合征的个体特征在社会经济地位较低阶层中的患病率有所上升。因此，本研究旨在评估葡萄牙城市中老年成年人样本中社会阶层与代谢综合征之间的关联。
我们评估了1962名年龄在40岁及以上的受试者（1207名女性和755名男性）。婚姻状况、教育程度、职业、初潮年龄和身高分布被用作社会经济指标。代谢综合征根据ATP III定义，具备以下至少三项特征：男性腰围>102厘米，女性腰围>88厘米；甘油三酯>或=150毫克/分升；男性高密度脂蛋白胆固醇<40毫克/分升，女性<50毫克/分升；血压>或=130/85毫米汞柱；空腹血糖>或=110毫克/分升。使用卡方检验或费舍尔精确检验比较比例。使用无条件逻辑回归计算比值比（OR）和95%置信区间（95%CI），以估计关联的程度。
代谢综合征在女性中显著更常见（24.9对17.4，p<0.001）。在女性中，如职业所描述的那样，随着年龄增长和社会阶层不利，患代谢综合征的几率显著增加，而随着教育水平的提高而降低。在男性中，与40-49岁年龄组相比，60-69岁年龄组的代谢综合征显著更常见（OR = 1.82；95%CI：1.02-3.26）。关于其他社会经济指标，未发现显著关联。
本研究表明，性别影响社会经济地位指标与代谢综合征之间的关联。根据教育和职业分类定义的社会阶层较低的女性更频繁地出现代谢综合征，而在男性中未发现这种关联。
