Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
BMJ Open. 2017 Dec 21;7(12):e016949. doi: 10.1136/bmjopen-2017-016949.
Immune response to cytomegalovirus (CMV) impacts adult chronic disease. This study investigates associations of childhood and adulthood social environment, socioeconomic position (SEP) and social mobility with CMV response in young adults.
Historical prospective study design.
Subcohort of all 17 003 births to residents of Jerusalem between 1974 and 1976.
Participants included 1319 young adults born in Jerusalem with extensive archival and follow-up data, including childhood and adulthood SEP-related factors and anti-CMV IgG titre levels and seroprevalence measured at age 32.
Principal component analysis was used to transform correlated social environment and SEP-related variables at two time points (childhood and adulthood) into two major scores reflecting household (eg, number of siblings/children, religiosity) and socioeconomic (eg, occupation, education) components. Based on these components, social mobility variables were created. Linear and Poisson regression models were used to investigate associations of components and mobility with anti-CMV IgG titre level and seroprevalence, adjusted for confounders.
Lower levels of household and socioeconomic components in either childhood or adulthood were associated with higher anti-CMV IgG titre level and seropositivity at age 32. Compared with individuals with stable favourable components, anti-CMV IgG titre level and risk for seropositivity were higher in stable unfavourable household and socioeconomic components (household: β=3.23, P<0.001; relative risk (RR)=1.21, P<0.001; socioeconomic: β=2.20, P=0.001; RR=1.14, P=0.01), downward household mobility (β=4.32, P<0.001; RR=1.26, P<0.001) and upward socioeconomic mobility (β=1.37, P=0.04; RR=1.19, P<0.001). Among seropositive individuals, associations between household components and mobility with anti-CMV IgG titre level were maintained and associations between socioeconomic components and mobility with anti-CMV IgG titre level were attenuated.
Our study provides evidence that accumulating low SEP from childhood through adulthood and social mobility may compromise immune response in young adulthood.
巨细胞病毒（CMV）的免疫反应会影响成年人的慢性疾病。本研究旨在探讨儿童期和成年期社会环境、社会经济地位（SEP）和社会流动与年轻人 CMV 反应之间的关联。
历史前瞻性研究设计。
1974 年至 1976 年期间，耶路撒冷居民中所有 17003 名出生者的子队列。
研究对象包括耶路撒冷出生的 1319 名年轻人，他们拥有广泛的档案和随访数据，包括儿童期和成年期的 SEP 相关因素以及在 32 岁时测量的抗 CMV IgG 滴度水平和血清阳性率。
采用主成分分析将两个时间点（儿童期和成年期）的相关社会环境和 SEP 相关变量转化为两个主要分数，反映家庭（例如，兄弟姐妹/孩子的数量、宗教信仰）和社会经济（例如，职业、教育）成分。基于这些成分，创建了社会流动变量。使用线性和泊松回归模型，在调整混杂因素后，研究了成分和流动性与抗 CMV IgG 滴度水平和血清阳性率的关联。
儿童期或成年期家庭和社会经济成分较低与 32 岁时更高的抗 CMV IgG 滴度水平和血清阳性率相关。与稳定有利的成分相比，稳定不利的家庭和社会经济成分的抗 CMV IgG 滴度水平和血清阳性风险更高（家庭：β=3.23，P<0.001；相对风险（RR）=1.21，P<0.001；社会经济：β=2.20，P=0.001；RR=1.14，P=0.01）、家庭向下流动（β=4.32，P<0.001；RR=1.26，P<0.001）和社会经济向上流动（β=1.37，P=0.04；RR=1.19，P<0.001）。在血清阳性个体中，家庭成分和流动性与抗 CMV IgG 滴度水平之间的关联得以维持，而社会经济成分和流动性与抗 CMV IgG 滴度水平之间的关联则减弱。
本研究提供的证据表明，从儿童期到成年期累积的低 SEP 和社会流动可能会损害年轻人的免疫反应。
