Tabassum Faiza, Kumari Meena, Rumley Ann, Power Chris, Strachan David P, Lowe Gordon
Third Sector Research Centre, Faculty of Human and Social Sciences, University of Southampton, Southampton, United Kingdom; Department of Infection and Population Health, University College London (UCL), London, United Kingdom.
Department of Epidemiology and Public Health, University College London (UCL), London, United Kingdom; ISER, Essex University, Wivenhoe Park, Colchester, United Kingdom.
PLoS One. 2014 May 8;9(5):e93277. doi: 10.1371/journal.pone.0093277. eCollection 2014.
The aim is to examine the association of lifecourse socioeconomic position (SEP) on circulating levels of D-dimer. Data from the 1958 British birth cohort were used, social class was determined at three stages of respondents' life: at birth, at 23 and at 42 years. A cumulative indicator score of SEP (CIS) was calculated ranging from 0 (always in the highest social class) to 9 (always in the lowest social class). In men and women, associations were observed between CIS and D-dimer (P<0.05). Thus, the respondents in more disadvantaged social classes had elevated levels of D-dimer compared to respondents in less disadvantaged social class. In multivariate analyses, the association of disadvantaged social position with D-dimer was largely explained by fibrinogen, C-reactive protein and von Willebrand Factor in women, and additionally by smoking, alcohol consumption and physical activity in men. Socioeconomic circumstances across the lifecourse at various stages also contribute independently to raised levels of D-dimer in middle age in women only. Risk exposure related to SEP accumulates across life and contributes to raised levels of D-dimer. The association of haemostatic markers and social differences in health may be mediated by inflammatory and other markers.
目的是研究生命历程社会经济地位（SEP）与D-二聚体循环水平之间的关联。使用了1958年英国出生队列的数据，社会阶层在受访者生命的三个阶段确定：出生时、23岁时和42岁时。计算了SEP的累积指标得分（CIS），范围从0（始终处于最高社会阶层）到9（始终处于最低社会阶层）。在男性和女性中，观察到CIS与D-二聚体之间存在关联（P<0.05）。因此，与处于较不弱势社会阶层的受访者相比，处于更弱势社会阶层的受访者D-二聚体水平升高。在多变量分析中，女性中弱势社会地位与D-二聚体的关联在很大程度上由纤维蛋白原、C反应蛋白和血管性血友病因子解释，而男性中还由吸烟、饮酒和身体活动解释。生命历程中不同阶段的社会经济状况也仅在中年女性中独立导致D-二聚体水平升高。与SEP相关的风险暴露在一生中积累，并导致D-二聚体水平升高。止血标志物与健康方面社会差异之间的关联可能由炎症和其他标志物介导。
