Kavikondala S, Schooling C M, Jiang C Q, Zhang W S, Cheng K K, Lam T H, Leung G M
Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Int J Epidemiol. 2009 Feb;38(1):72-82. doi: 10.1093/ije/dyn221. Epub 2008 Nov 26.
'Environmental mismatch' may contribute to obesity in rapidly developing societies, because poor early life conditions could increase the risk of obesity in a subsequently more socio-economically developed environment. In a recently developing population (from southern China) we examined the association of life-course socio-economic position (SEP) with obesity.
In a cross-sectional study of 9998 adults from the Guangzhou Biobank Cohort Study (phase 2) examined in 2005-06, we used multivariable linear regression to assess the association of SEP at three life stages (proxied by parental possessions, education and longest held occupation) with obesity [body mass index (BMI) and waist-hip ratio (WHR)] in men and women.
There was no evidence that socio-economic position trajectory had supra-additive effects on BMI or WHR. Instead in women, higher SEP at any life stage usually contributed to lower BMI and WHR; e.g. women with higher early adult SEP had lower BMI [-0.45; 95% confidence interval (CI) -0.71 to -0.19) and WHR (-0.02; 95% CI -0.02 to -0.012]. In contrast, in men, higher childhood SEP was associated with higher BMI (0.53; 95% CI 0.18 to 0.88) and WHR (0.01; 95% CI 0.003 to 0.02) as was high late adulthood SEP with BMI (0.36; 95% CI 0.07 to 0.64).
This study provides little support for environmental mismatch over the life course increasing obesity in this rapidly transitioning southern Chinese population. However, our findings highlight different effects of the epidemiologic transition in men and women, perhaps with pre-adult exposures as a critical window for sex-specific effects.
在快速发展的社会中，“环境错配”可能导致肥胖，因为早期生活条件较差可能会增加在随后社会经济更发达的环境中患肥胖症的风险。在一个近期发展起来的人群（来自中国南方）中，我们研究了生命历程中的社会经济地位（SEP）与肥胖之间的关联。
在2005 - 2006年对广州生物样本库队列研究（第二阶段）的9998名成年人进行的横断面研究中，我们使用多变量线性回归来评估三个生命阶段的SEP（以父母财产、教育程度和最长从事的职业为代理指标）与男性和女性肥胖症[体重指数（BMI）和腰臀比（WHR）]之间的关联。
没有证据表明社会经济地位轨迹对BMI或WHR有超相加效应。相反，在女性中，任何生命阶段较高的SEP通常会导致较低的BMI和WHR；例如，成年早期SEP较高的女性BMI较低[-0.45；95%置信区间（CI）-0.71至-0.19]，WHR较低（-0.02；95% CI -0.02至-0.012）。相比之下，在男性中，儿童期SEP较高与较高的BMI（0.53；95% CI 0.18至0.88）和WHR（0.01；95% CI 0.003至0.02）相关，成年晚期SEP较高也与BMI较高相关（0.36；95% CI 0.07至0.64）。
本研究几乎没有支持在这个快速转型的中国南方人群中，生命历程中的环境错配会增加肥胖症的观点。然而，我们的研究结果突出了男女在流行病学转变中的不同影响，也许成年前的暴露是性别特异性影响的关键窗口。
