Department of Paediatrics, Faculty of Medicine, Dentistry and Health Services, University of Melbourne, Parkville, Australia.
Murdoch Children's Research Institute, Parkville, Australia.
J Am Heart Assoc. 2017 Aug 9;6(8):e005925. doi: 10.1161/JAHA.117.005925.
Lower socioeconomic position (SEP) predicts higher cardiovascular risk in adults. Few studies differentiate between neighborhood and family SEP or have repeated measures through childhood, which would inform understanding of potential mechanisms and the timing of interventions. We investigated whether neighborhood and family SEP, measured biennially from ages 0 to 1 year onward, was associated with carotid intima-media thickness (IMT) at ages 11 to 12 years.
Data were obtained from 1477 families participating in the Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children. Disadvantaged family and neighborhood SEP was cross-sectionally associated with thicker maximum carotid IMT in separate univariable linear regression models. Associations with family SEP were not attenuated in multivariable analyses, and associations with neighborhood SEP were attenuated only in models adjusted for family SEP. The difference in maximum carotid IMT between the highest and lowest family SEP quartile measured at ages 10 to 11 years was 10.7 μm (95% CI, 3.4-18.0; =0.004), adjusted for age, sex, pubertal status, passive smoking exposure, body mass index, blood pressure, and arterial lumen diameter. In longitudinal analyses, family SEP measured as early as age 2 to 3 years was associated with maximum carotid IMT at ages 11 to 12 years (difference between highest and lowest quartile: 8.5 μm; 95% CI, 1.3-15.8; =0.02). No associations were observed between SEP and mean carotid IMT.
We report a robust association between lower SEP in early childhood and carotid IMT in mid-childhood. Further investigation of mechanisms may inform pediatric cardiovascular risk assessment and prevention strategies.
较低的社会经济地位（SEP）预示着成年人的心血管风险更高。很少有研究区分邻里和家庭 SEP，或通过儿童期进行重复测量，这将有助于了解潜在的机制和干预时机。我们调查了从 0 岁到 1 岁起每两年测量一次的邻里和家庭 SEP 是否与 11 至 12 岁时的颈动脉内膜-中层厚度（IMT）有关。
数据来自于参与儿童健康检查点研究的 1477 个家庭，该研究嵌套在澳大利亚儿童纵向研究中。在单独的单变量线性回归模型中，处于不利地位的家庭和邻里 SEP 与颈动脉最大 IMT 增厚呈横断面相关。在多变量分析中，家庭 SEP 的关联并未减弱，而邻里 SEP 的关联仅在调整家庭 SEP 的模型中减弱。在 10 至 11 岁时测量的最高和最低家庭 SEP 四分位组之间，颈动脉最大 IMT 的差异为 10.7μm（95%CI，3.4-18.0；=0.004），调整了年龄、性别、青春期状态、被动吸烟暴露、体重指数、血压和动脉管腔直径。在纵向分析中，早在 2 至 3 岁就测量的家庭 SEP 与 11 至 12 岁时的颈动脉最大 IMT 相关（最高和最低四分位组之间的差异：8.5μm；95%CI，1.3-15.8；=0.02）。SEP 与颈动脉平均 IMT 之间没有关联。
我们报告了儿童早期较低的 SEP 与儿童中期颈动脉 IMT 之间存在强有力的关联。对机制的进一步研究可能为儿科心血管风险评估和预防策略提供信息。
