Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands.
BMC Public Health. 2012 Aug 1;12:591. doi: 10.1186/1471-2458-12-591.
Socioeconomic inequalities in cardiovascular disease are pervasive, yet much remains to be understood about how they originate. The objective of this study was to explore the relations of socioeconomic status to lipid and glucose metabolism as indicators of cardiovascular health in 5-6 year olds. Additionally to explore the explanatory role of maternal factors, birth outcome, and child factors.
In 1308 5-6 year old ethnic Dutch children from the ABCD cohort study, lipids (cholesterol, LDL, HDL, triglycerides), glucose and C-peptide were measured after an overnight-fast.
There were no differences in cholesterol, HDL, LDL, and triglycerides between socioeconomic groups, as indicated by maternal education and income adequacy. However, children of low educated mothers had on average a higher glucose (β = 0.15; 95% confidence interval (CI) 0.03 - 0.27), logC-peptide (β = 0.07; 95% CI 0.04 - 0.09), and calculated insulin resistance (HOMA-IR) (β = 0.15; 95% CI 0.08 - 0.22) compared to children of high educated mothers. Only childhood BMI partly explained these differences (models controlled for age, height, and sex).
The socioeconomic gradient in cardiovascular risk factors seems to emerge in early childhood. In absence of underlying mechanisms these empirical findings are relevant for public health care and further explanatory research.
心血管疾病的社会经济不平等现象普遍存在,但对于其起源仍有许多需要了解的地方。本研究旨在探讨社会经济地位与血脂和葡萄糖代谢之间的关系,以评估它们作为心血管健康的指标。此外,还探讨了母亲因素、出生结局和儿童因素的解释作用。
在 ABCD 队列研究的 1308 名 5-6 岁的荷兰裔儿童中,在隔夜禁食后测量了血脂(胆固醇、LDL、HDL、甘油三酯)、血糖和 C 肽。
根据母亲的教育程度和收入充足性,社会经济群体之间在胆固醇、HDL、LDL 和甘油三酯方面没有差异。然而,母亲受教育程度低的儿童的平均血糖(β=0.15;95%置信区间(CI)0.03-0.27)、logC 肽(β=0.07;95%CI 0.04-0.09)和计算出的胰岛素抵抗(HOMA-IR)(β=0.15;95%CI 0.08-0.22)较高。仅儿童 BMI 部分解释了这些差异(模型中控制了年龄、身高和性别)。
心血管危险因素的社会经济梯度似乎在儿童早期就出现了。在缺乏潜在机制的情况下,这些经验性发现与公共医疗保健和进一步的解释性研究有关。