Department of Biostatistics, Christian Medical College, Vellore, Tamilnadu, India.
Int J Epidemiol. 2012 Oct;41(5):1315-27. doi: 10.1093/ije/dys001. Epub 2012 Feb 24.
We examined associations between socio-economic status (SES) indicators and cardiovascular disease (CVD) risk factors among urban and rural South Indians.
Data from a population-based birth cohort of 2218 men and women aged 26-32 years from Vellore, Tamilnadu were used. SES indicators included a household possessions score, attained education and paternal education. CVD risk factors included obesity, hypertension, impaired glucose tolerance or diabetes, plasma total cholesterol to high density lipoprotein (HDL) ratio and triglyceride levels and consumption of tobacco and alcohol. Multiple logistic regression analysis was used to assess associations between SES indicators and risk factors.
Most risk factors were positively associated with possessions score in urban and rural men and women, except for tobacco use, which was negatively associated. Trends were similar with the participants' own education and paternal education, though weaker and less consistent. In a concurrent analysis of all the three SES indicators, adjusted for gender and urban/rural residence, independent associations were observed only for the possessions score. Compared with those in the lowest fifth of the score, participants in the highest fifth had a higher risk of abdominal obesity [odds ratio (OR) =6.4, 95% CI 3.4-11.6], high total cholesterol to HDL ratio (OR=2.4, 95% CI 1.6-3.5) and glucose intolerance (OR=2.8, 95% CI 1.9-4.1). Their tobacco use (OR=0.4, 95% CI 0.2-0.6) was lower. Except for hypertension and glucose intolerance, risk factors were higher in urban than rural participants independently of SES.
In this young cohort of rural and urban south Indians, higher SES was associated with a more adverse CVD risk factor profile but lower tobacco use.
我们研究了社会经济地位（SES）指标与南印度城乡人群心血管疾病（CVD）危险因素之间的关系。
本研究使用了来自泰米尔纳德邦维洛尔的一个基于人群的 2218 名 26-32 岁男性和女性的出生队列数据。SES 指标包括家庭财产评分、受教育程度和父亲的受教育程度。CVD 危险因素包括肥胖、高血压、糖耐量受损或糖尿病、血浆总胆固醇与高密度脂蛋白（HDL）比值和甘油三酯水平以及烟草和酒精的使用。多因素逻辑回归分析用于评估 SES 指标与危险因素之间的关系。
在城乡男性和女性中，大多数危险因素与财产评分呈正相关，除了吸烟，其与评分呈负相关。与参与者自己的教育和父亲的教育相比，这种趋势相似，但较弱且不一致。在同时分析所有三个 SES 指标时，在调整性别和城乡居住后，仅发现财产评分具有独立相关性。与评分最低的五分之一参与者相比，评分最高的五分之一参与者发生腹部肥胖的风险更高[比值比（OR）=6.4，95%可信区间（CI）为 3.4-11.6]、总胆固醇与 HDL 比值较高（OR=2.4，95% CI 1.6-3.5）和葡萄糖耐量受损（OR=2.8，95% CI 1.9-4.1）。他们的烟草使用（OR=0.4，95% CI 0.2-0.6）较低。除了高血压和葡萄糖耐量受损外，无论 SES 如何，城市参与者的危险因素均高于农村参与者。
在这个来自南印度城乡的年轻队列中，较高的 SES 与更不利的 CVD 危险因素谱相关，但与较低的烟草使用相关。
