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儿童时期社会经济地位对成年后患代谢综合征和葡萄糖异常的预测作用:芬兰年轻人心血管风险研究。

Childhood Socioeconomic Status in Predicting Metabolic Syndrome and Glucose Abnormalities in Adulthood: The Cardiovascular Risk in Young Finns Study.

机构信息

Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.

出版信息

Diabetes Care. 2016 Dec;39(12):2311-2317. doi: 10.2337/dc16-1565. Epub 2016 Oct 18.

Abstract

OBJECTIVE

We prospectively examined whether family socioeconomic status (SES) in childhood is associated with metabolic syndrome (MetS), impaired fasting glucose (IFG), or type 2 diabetes in adulthood.

RESEARCH DESIGN AND METHODS

The sample comprised 2,250 participants from the longitudinal Cardiovascular Risk in Young Finns Study cohort. Participants were 3-18 years old at baseline (mean age 10.6 years), and they were followed for 31 years. SES was characterized as reported annual income of the family and classified on an 8-point scale.

RESULTS

For each 1-unit increase in family SES in childhood, the risk for adult MetS decreased (risk ratio [95% confidence interval] 0.94 [0.90-0.98]; P = 0.003) when adjusted for age, sex, childhood cardiometabolic risk factors (lipids, systolic blood pressure, insulin, and BMI), childhood physical activity, and fruit and vegetable consumption. The association remained after adjustment for participants' own SES in adulthood (0.95 [0.91-0.99]; P = 0.005). A similar association was seen between childhood SES and the risk of having either adult IFG or type 2 diabetes (0.96 [0.92-0.99]; P = 0.01, age and sex adjusted). This association became nonsignificant after adjustment for childhood risk factors (P = 0.08). Of the individual components of MetS, lower SES in childhood predicted large waist circumference (0.96 [0.93-0.99]; P = 0.003) and a high triglycerides concentration (0.96 [0.92-1.00]; P = 0.04) after adjustment for the aforementioned risk factors.

CONCLUSIONS

Lower SES in childhood may be associated with an increased risk for MetS, IFG, and type 2 diabetes in adulthood. Special attention could be paid to children of low SES families to decrease the prevalence of MetS in adulthood.

摘要

目的

我们前瞻性地研究了儿童时期家庭社会经济地位(SES)是否与成年期代谢综合征(MetS)、空腹血糖受损(IFG)或 2 型糖尿病有关。

研究设计和方法

本研究样本包括来自纵向心血管风险在年轻芬兰人研究队列的 2250 名参与者。参与者在基线时年龄为 3-18 岁(平均年龄 10.6 岁),随访时间为 31 年。SES 特征为家庭年收入报告,并按 8 分制进行分类。

结果

在校正年龄、性别、儿童期心血管代谢危险因素(血脂、收缩压、胰岛素和 BMI)、儿童期体力活动和水果及蔬菜摄入量后,儿童时期家庭 SES 每增加 1 个单位,成年期 MetS 的发病风险降低(风险比[95%置信区间]0.94[0.90-0.98];P=0.003)。在校正成年参与者自身 SES 后,这种关联仍然存在(0.95[0.91-0.99];P=0.005)。儿童期 SES 与成年期 IFG 或 2 型糖尿病风险之间也存在类似的关联(0.96[0.92-0.99];P=0.01,年龄和性别校正)。在校正儿童期危险因素后,这种关联变得无统计学意义(P=0.08)。在调整上述危险因素后,儿童期 SES 较低预测腰围较大(0.96[0.93-0.99];P=0.003)和甘油三酯浓度较高(0.96[0.92-1.00];P=0.04)。

结论

儿童时期 SES 较低可能与成年期 MetS、IFG 和 2 型糖尿病的风险增加有关。可以特别关注 SES 较低家庭的儿童,以降低成年期 MetS 的患病率。

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