MRC National Survey of Healthand Development, MRC Unit for Lifelong Health and Ageing, London, UK.
J Epidemiol Community Health. 2012 Jun;66(6):512-8. doi: 10.1136/jech.2010.115220. Epub 2010 Nov 23.
In this study, the authors investigate gender-specific effects of childhood socio-economic position (SEP) on adiposity and blood pressure at three time points in adulthood.
Mixed models were used to assess the association of childhood SEP with body mass index (BMI), waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at ages 36, 43 and 53 years in a British birth cohort.
The adverse effect of lower childhood SEP on adiposity increased between ages 36 and 53 years in women (BMI: trend test: p=0.03) and remained stable in men, but the opposite was seen for SBP, where inequalities increased in men (p=0.01). Childhood SEP inequalities in DBP were stable with age in both men and women. Educational attainment mediated some but not all of the effects of childhood SEP on adiposity and SBP, and their rate of change; adult social class was a less important mediator.
Childhood SEP is important for adult adiposity and blood pressure across midlife, especially for BMI in women and for blood pressure in men. Thus, pathways to adult health differ for men and women, and public health policies aimed at reducing social inequalities need to start early in life and take account of gender.
本研究旨在探讨儿童时期社会经济地位(SEP)对成年后三个时间点肥胖和血压的性别特异性影响。
采用混合模型评估了儿童时期 SEP 与身体质量指数(BMI)、腰围、收缩压(SBP)和舒张压(DBP)在英国出生队列中 36、43 和 53 岁时的相关性。
在女性中,较低的儿童时期 SEP 对肥胖的不利影响在 36 至 53 岁之间增加(BMI:趋势检验:p=0.03),而在男性中则保持稳定,但 SBP 则相反,男性的不平等程度增加(p=0.01)。男女儿童时期 SEP 对 DBP 的不平等与年龄相关,且稳定。受教育程度部分中介了儿童时期 SEP 对肥胖和 SBP 及其变化率的影响;而成人社会阶层是一个不太重要的中介因素。
儿童时期 SEP 对成年后肥胖和血压具有重要意义,尤其是对女性的 BMI 和男性的血压。因此,男性和女性的成年健康途径不同,旨在减少社会不平等的公共卫生政策需要从生命早期开始,并考虑到性别差异。