Steinvil Arie, Shirom Arie, Melamed Samuel, Toker Sharon, Justo Dan, Saar Nili, Shapira Itzhak, Berliner Shlomo, Rogowski Ori
Department of Internal Medicine D, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Am J Cardiol. 2008 Oct 15;102(8):1034-9. doi: 10.1016/j.amjcard.2008.05.055. Epub 2008 Jul 26.
It is a well-established finding that cardiovascular morbidity varies among groups of different socioeconomic status. Inflammatory processes have been proposed as a possible mediator of this variance. Level of education is an important indicator of socioeconomic status, inversely related to levels of inflammatory biomarkers. Whether this association was significant in a subpopulation of highly educated individuals was questioned. This cross-sectional study enrolled attendees of an executive health screening program intended specifically for executive and high-wage personnel from September 2002 to November 2007. A detailed questionnaire, anthropometric measurements, and laboratory data were used to determine self-reported years of education and cardiovascular risk factors. Linear regression models included high-sensitivity C-reactive protein, fibrinogen, erythrocyte sedimentation rate, and white blood cell count as dependent variables and were adjusted for multiple potential confounders. Data for 8,998 subjects (5,757 men, 3,241 women) with a mean age of 44 years (range 18 to 84) were analyzed. More than two-thirds reported >or=14 years of schooling, and >2,900 reported >or=17 years of schooling. We found a statistically significant inverse association between number of school years and high-sensitivity C-reactive protein, fibrinogen, and erythrocyte sedimentation rate. Higher levels of education were associated with lower prevalences of diabetes and current smoking in both genders and lower prevalences of hypertension and dyslipidemia in women. In conclusion, level of education was inversely associated with inflammatory biomarkers and prevalence of cardiovascular risk factors, even within highly educated populations.
心血管疾病的发病率在不同社会经济地位群体中存在差异,这是一个已被充分证实的发现。炎症过程被认为可能是这种差异的一个中介因素。教育水平是社会经济地位的一个重要指标,与炎症生物标志物水平呈负相关。但这种关联在高学历人群亚组中是否显著仍存疑问。这项横断面研究纳入了2002年9月至2007年11月期间专门针对企业高管和高薪人员开展的高管健康筛查项目的参与者。通过详细问卷、人体测量和实验室数据来确定自我报告的受教育年限和心血管危险因素。线性回归模型将高敏C反应蛋白、纤维蛋白原、红细胞沉降率和白细胞计数作为因变量,并对多个潜在混杂因素进行了调整。分析了8998名受试者(5757名男性,3241名女性)的数据,平均年龄44岁(范围18至84岁)。超过三分之二的人报告受教育年限≥14年,超过2900人报告受教育年限≥17年。我们发现受教育年限与高敏C反应蛋白、纤维蛋白原和红细胞沉降率之间存在统计学上显著的负相关。较高的教育水平与男女糖尿病患病率和当前吸烟率较低以及女性高血压和血脂异常患病率较低相关。总之,即使在高学历人群中,教育水平也与炎症生物标志物和心血管危险因素患病率呈负相关。