University of Pennsylvania, Department of Psychology, 425 S. University Avenue, Philadelphia, PA 19104, United States.
University of Pennsylvania, Department of Psychology, 425 S. University Avenue, Philadelphia, PA 19104, United States.
Brain Behav Immun. 2019 May;78:161-176. doi: 10.1016/j.bbi.2019.01.018. Epub 2019 Feb 7.
Recent research suggests that risk for chronic diseases of aging including cardiovascular disease, diabetes, and even cancer can be programmed early in the lifespan as a result of exposure to chronic stressors like low socioeconomic status (SES) that are hypothesized to promote a pro-inflammatory response in immune cells that results in chronic, systemic inflammation. The present paper conducted a meta-analysis to establish whether exposure to low (versus higher) SES in childhood and adolescence is associated with higher levels of inflammation (as measured by C-reactive protein, IL-6, and fibrinogen) concurrently and in adulthood. We conducted meta-analyses with both unadjusted bivariate associations between SES and inflammation and with adjusted associations that controlled for a range of covariates including demographic factors, body mass index, smoking, physical activity and current SES. A systematic review of Pubmed and PsycINFO identified a total 35 studies (26 with unadjusted and 31 adjusted effect sizes) to be included in the meta-analysis. Random-effects meta-analysis showed that individuals who were exposed to low SES in childhood and adolescence had significantly higher levels of inflammatory markers (r = -0.07, p < .001, 95% CI = -0.09, -0.05). This association remained significant in adjusted analyses (r = -0.06, p < .001, 95% CI = -0.09, -0.03). However, the relationship between childhood SES and inflammation was non-significant in a meta-analysis with longitudinal studies that all controlled for adulthood SES (r = -0.03, p = .356, 95% CI = -0.08, 0.03). Future longitudinal research should utilize measurement of inflammatory markers at multiple time points to further examine the complex relationships between SES and health both in childhood and adulthood.
最近的研究表明，由于暴露于慢性应激源（如低社会经济地位），慢性疾病的风险，包括心血管疾病、糖尿病，甚至癌症，可以在生命早期被编程，这些应激源被假设会促进免疫细胞中的促炎反应，从而导致慢性、全身性炎症。本文进行了荟萃分析，以确定儿童和青少年时期暴露于低（而非高）社会经济地位是否与成年时更高的炎症水平（通过 C 反应蛋白、IL-6 和纤维蛋白原测量）相关。我们进行了荟萃分析，包括 SES 与炎症之间未调整的二元关联和调整后的关联，这些关联控制了一系列协变量，包括人口统计学因素、体重指数、吸烟、体育活动和当前社会经济地位。在 Pubmed 和 PsycINFO 中进行了系统审查，共确定了 35 项研究（26 项未调整的和 31 项调整后的效应量）纳入荟萃分析。随机效应荟萃分析显示，儿童和青少年时期暴露于低社会经济地位的个体的炎症标志物水平显著更高（r= -0.07，p <.001，95%CI= -0.09，-0.05）。在调整后的分析中，这种关联仍然显著（r= -0.06，p <.001，95%CI= -0.09，-0.03）。然而，在一项荟萃分析中，所有研究都控制了成年社会经济地位，童年社会经济地位与炎症之间的关系在纵向研究中并不显著（r= -0.03，p=.356，95%CI= -0.08，0.03）。未来的纵向研究应利用多个时间点测量炎症标志物，以进一步研究儿童期和成年期社会经济地位与健康之间的复杂关系。
