Center for Child and Adolescent Health Research and Policy, 100 Cambridge St., Boston, MA 02114, USA.
Psychosom Med. 2013 Jun;75(5):442-8. doi: 10.1097/PSY.0b013e31828b871a. Epub 2013 Mar 26.
To determine whether lower socioeconomic status (SES), broadly defined, is associated with increased inflammation in adolescence and whether adiposity mediates these relationships.
Fasting blood samples from 941 non-Hispanic black and white adolescents enrolled in a suburban, Midwestern school district were assayed for proinflammatory biomarkers (interleukin-6 [IL-6], tumor necrosis factor α soluble receptor 2 fibrinogen). A parent reported objective SES (parent education [E1 ≤ high school, E2 = some college, E3 = college graduate, E4 = professional degree], household income), and youth perceived SES (PSES). Multivariable linear regressions assessed the relationship of SES measures to biomarkers adjusting for age, race, sex, and puberty status. In the final step, body mass index (BMI) z score (BMIz) was added to models, and Sobel tests were performed to assess mediation by adiposity.
Parent education was inversely associated with IL-6 (βE1 = .11, βE2 = .10, βE3 = .02; p < .001). This association was attenuated but remained significant after BMIz adjustment (p = .01). Sobel testing confirmed BMIz's partial mediating role (p < .001). Parent education was also inversely associated with sTNFR2 (βE1 = .03, βE2 = .02, βE3 = .001; p = .01); this relationship was mediated by BMIz. Although no main effect was noted for PSES, PSES by race interactions was observed for sTNFR2 (p = .02) and IL-6 (p = .06). High PSES was associated with lower sTNFR2 and IL-6 for white but not black youth. There were no associations with household income.
Social disadvantage, specifically low parent education, is associated with increased inflammation in adolescence. Adiposity explains some but not all associations, suggesting that other mechanisms link lower SES to inflammation. High PSES is associated with lower inflammation for white but not black youth.
确定广义的社会经济地位（SES）较低是否与青少年期炎症增加有关，以及肥胖是否会影响这些关系。
对参加中西部郊区学区的 941 名非西班牙裔黑人和白人青少年的空腹血样进行检测，以测定促炎生物标志物（白细胞介素-6[IL-6]、肿瘤坏死因子α可溶性受体 2 纤维蛋白原）。父母报告客观 SES（父母教育[E1≤高中学历，E2=大专学历，E3=本科学历，E4=专业学位]，家庭收入）和青少年感知 SES（PSES）。多变量线性回归评估 SES 测量指标与生物标志物的关系，调整年龄、种族、性别和青春期状态。在最后一步，将体质指数（BMI）z 评分（BMIz）添加到模型中，并进行 Sobel 检验以评估肥胖的中介作用。
父母教育与 IL-6 呈负相关（βE1=.11，βE2=.10，βE3=.02；p<.001）。在 BMIz 调整后，这种关联减弱但仍具有统计学意义（p=.01）。Sobel 检验证实 BMIz 具有部分中介作用（p<.001）。父母教育也与 sTNFR2 呈负相关（βE1=.03，βE2=.02，βE3=.001；p=.01）；这种关系受 BMIz 介导。虽然 PSES 没有主要影响，但观察到 PSES 与种族的交互作用对 sTNFR2（p=.02）和 IL-6（p=.06）有影响。高 PSES 与白种人青少年的 sTNFR2 和 IL-6 降低有关，但与黑种人青少年无关。与家庭收入无关联。
社会劣势，特别是低父母教育水平，与青少年期炎症增加有关。肥胖解释了部分但不是全部关联，这表明其他机制将较低的 SES 与炎症联系起来。高 PSES 与白种人青少年的炎症降低有关，但与黑种人青少年无关。
