Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany.
BMC Public Health. 2011 May 10;11:289. doi: 10.1186/1471-2458-11-289.
The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population.
Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term.
In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking.
We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects.
社会经济地位（SES）对心血管疾病和危险因素的影响是众所周知的，尽管不同 SES 指标的作用尚未完全了解。本研究旨在调查不同 SES 指标在中年和老年东德人群中对心血管疾病危险因素的作用。
使用基于东德人群的横断面研究（1779 名 45 至 83 岁的男性和女性）的数据，评估儿童期和成年 SES 指标（儿童期 SES、教育、职业地位、收入）与心血管危险因素的相关性。通过线性和逻辑回归模型，按性别计算 SES 指标与 95%置信区间（CI）的风险因素调整均值和比值比。通过包含交互项来检验教育和年龄对心血管危险因素的交互作用效应。
在年龄调整模型中，教育、职业地位和收入与男性的腹部肥胖以及两性的吸烟行为呈统计学显著相关。受教育程度低的男性吸烟的风险是三倍以上（OR 3.44，95%CI 1.58-7.51）。低儿童 SES 与女性的收缩压和腹部肥胖相关（OR 2.27，95%CI 1.18-4.38）；在男性中观察到儿童 SES 与吸烟的关联不显著，但（就效应大小而言）具有相关性。在女性中，年龄是教育对肥胖和吸烟风险的效应修饰因素。
我们发现，受教育程度、职业地位、收入以及部分儿童社会地位的差异与心血管危险因素存在显著差异，且这些差异因性别而异。一些社会不平等现象在较高年龄时趋于平稳。需要进行纵向研究来区分年龄和出生队列效应。
