Niedzwiedz Claire L, Katikireddi Srinivasa Vittal, Reeves Aaron, McKee Martin, Stuckler David
Department of Sociology, University of Oxford, Oxford, UK.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
J Epidemiol Community Health. 2017 Oct;71(10):1005-1013. doi: 10.1136/jech-2017-209105. Epub 2017 Aug 30.
Economic insecurity correlates with adverse health outcomes, but the biological pathways involved are not well understood. We examine how changes in economic insecurity relate to metabolic, inflammatory and liver function biomarkers.
Blood analyte data were taken from 6520 individuals (aged 25-59 years) participating in Understanding Society. Economic insecurity was measured using an indicator of subjective financial strain and by asking participants whether they had missed any bill, council tax, rent or mortgage payments in the past year. We investigated longitudinal changes in economic insecurity (remained secure, increase in economic insecurity, decrease in economic insecurity, remained insecure) and the accumulation of economic insecurity. Linear regression models were calculated for nine (logged) biomarker outcomes related to metabolic, inflammatory, liver and kidney function (as falsification tests), adjusting for potential confounders.
Compared with those who remained economically stable, people who experienced consistent economic insecurity (using both measures) had worsened levels of high-density lipoprotein (HDL)-cholesterol, triglycerides, C reactive protein (CRP), fibrinogen and glycated haemoglobin. Increased economic insecurity was associated with adverse levels of HDL-cholesterol (0.955, 95% CI 0.929 to 0.982), triglycerides (1.077, 95% CI 1.018 to 1.139) and CRP (1.114, 95% CI 1.012 to 1.227), using the measure of financial strain. Results for the other measure were generally consistent, apart from the higher levels of gamma-glutamyl transferase observed among those experiencing persistent insecurity (1.200, 95% CI 1.110 to 1.297).
Economic insecurity is associated with adverse metabolic and inflammatory biomarkers (particularly HDL-cholesterol, triglycerides and CRP), heightening risk for a range of health conditions.
经济不安全感与不良健康结果相关,但其中涉及的生物学途径尚不清楚。我们研究经济不安全感的变化如何与代谢、炎症和肝功能生物标志物相关。
血液分析物数据取自参与“理解社会”项目的6520名年龄在25至59岁之间的个体。经济不安全感通过主观财务压力指标来衡量,并询问参与者在过去一年中是否有任何账单、市政税、租金或抵押贷款未支付。我们调查了经济不安全感的纵向变化(保持安全、经济不安全感增加、经济不安全感降低、保持不安全)以及经济不安全感的累积情况。针对与代谢、炎症、肝脏和肾脏功能相关的九种(对数转换后的)生物标志物结果计算线性回归模型(作为验证测试),并对潜在混杂因素进行调整。
与经济状况保持稳定的人相比,经历持续经济不安全感(使用两种衡量方法)的人,其高密度脂蛋白(HDL)胆固醇、甘油三酯、C反应蛋白(CRP)、纤维蛋白原和糖化血红蛋白水平更差。使用财务压力衡量方法时,经济不安全感增加与HDL胆固醇(0.955,95%置信区间0.929至0.982)、甘油三酯(1.077,95%置信区间1.018至1.139)和CRP(1.114,95%置信区间1.012至1.227)的不良水平相关。另一种衡量方法的结果总体一致,但在经历持续不安全感的人群中观察到γ-谷氨酰转移酶水平较高(1.200,95%置信区间1.110至1.297)。
经济不安全感与不良的代谢和炎症生物标志物(特别是HDL胆固醇、甘油三酯和CRP)相关,增加了一系列健康状况的风险。