儿童社会经济地位与成人血压变化关联的性别差异：CARDIA 研究。
Sex differences in the association of childhood socioeconomic status with adult blood pressure change: the CARDIA study.
机构信息
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
出版信息
Psychosom Med. 2012 Sep;74(7):728-35. doi: 10.1097/PSY.0b013e31825e32e8. Epub 2012 Jul 20.
OBJECTIVE
To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic blood pressure (DBP) trajectories during 15 years, spanning young (mean [M] [standard deviation {SD}] = 30 [3] years) and middle (M [SD] = 45 [3] years) adulthood, independent of adult SES.
METHODS
A total of 4077 adult participants reported father's and mother's educational attainments at study enrollment (Year 0) and own educational attainment at enrollment and at all follow-up examinations. Resting BP also was measured at all examinations. Data from examination Years 5 (when participant M [SD] age = 30 [3] years), 7, 10, 15, and 20 are examined here. Associations of own adult (Year 5), mother's, and father's educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center) and time-varying covariates that were measured at each examination (marital status, body mass, cholesterol, oral contraceptives/hormones, and antihypertensive drugs). Analyses of parental education controlled for own education.
RESULTS
When examined without covariates, higher education - own (SBP γ = -0.03, DBP γ = -0.03), mother's (SBP γ = -0.02, DBP γ = -0.02), and father's (SBP γ = -0.02, DBP γ = -0.01) - were associated with attenuated 15-year increases in BP (p < .001). Associations of own (but not either parent's) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education-especially mother's, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ = -0.02, p = .02; DBP γ = -0.01, p = .04) but not men (SBP γ = 0.02, p = .06; DBP γ = 0.005, p = .47; p interaction SBP < .001, p interaction DBP = .01).
CONCLUSIONS
Childhood socioeconomic status may influence women's health independent of their own adult status.
目的
研究童年社会经济地位（CSES）与收缩压（SBP）和舒张压（DBP）在 15 年内的轨迹之间的关系，该研究跨越了年轻（平均[M] [标准差{SD}] = 30 [3]岁）和中年（M [SD] = 45 [3]岁）成年期，独立于成年期 SES。
方法
共有 4077 名成年参与者在研究入组时（第 0 年）报告了父亲和母亲的教育程度，以及在入组时和所有随访检查时的自身教育程度。所有检查均测量静息血压。此处检查了检查年份 5（当参与者 M [SD]年龄= 30 [3]岁），7、10、15 和 20 的数据。在单独的多层次模型中，分别研究了自身成人（第 5 年）、母亲和父亲的教育程度与 15 年 BP 轨迹的关系。完全控制模型包括不变协变量（年龄、性别、种族、招募中心）和每个检查时测量的时变协变量（婚姻状况、体重、胆固醇、口服避孕药/激素、和抗高血压药物）。父母教育的分析控制了自身教育。
结果
在没有协变量的情况下，较高的教育程度-自身（SBP γ = -0.03，DBP γ = -0.03）、母亲（SBP γ = -0.02，DBP γ = -0.02）和父亲（SBP γ = -0.02，DBP γ = -0.01）与 15 年内血压升高幅度降低有关（p <.001）。自身教育程度（但不是父母任何一方的教育程度）与 BP 轨迹的关联仍然独立于标准控制。性别调节了父母教育的明显无效作用，以至于较高的父母教育程度-尤其是母亲的教育程度，独立于标准协变量，可预测女性的血压轨迹降低（SBP γ = -0.02，p =.02；DBP γ = -0.01，p =.04），但不能预测男性（SBP γ = 0.02，p =.06；DBP γ = 0.005，p =.47；p 交互 SBP <.001，p 交互 DBP =.01）。
结论
童年社会经济地位可能会影响女性的健康，而与她们自己的成年期状况无关。
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