Department of Medicine and Health, Linköping University, Linköping, Sweden
Crown Princess Victoria Children's Hospital, Linköping University Hospital, Linkoping, Sweden.
BMJ Open. 2020 Feb 20;10(2):e030613. doi: 10.1136/bmjopen-2019-030613.
To investigate if socioeconomic status (SES) is predictive of cardiovascular risk factors among Swedish adolescents. Identify the most important SES variable for the development of each cardiovascular risk factor. Investigate at what age SES inequality in overweight and obesity occurs.
Longitudinal follow-up of a prospective birth cohort.
All Babies in Southeast Sweden (ABIS) study includes data from children born between October 1997 and October 1999 in five counties of south east Sweden.
A regional ABIS-study subsample from three major cities of the region n=298 adolescents aged 16-18 years, and prospective data from the whole ABIS cohort for overweight and obesity status at the ages 2, 5, 8 and 12 years (n=2998-7925).
Blood pressure above the hypertension limit, overweight/obesity according to the International Obesity Task Force definition, low high-density lipoproteins (HDL) or borderline-high low-density lipoproteins according to National Cholesterol Education Program expert panel on cholesterol levels in children.
For three out of four cardiovascular risk outcomes (elevated blood pressure, low HDL and overweight/obesity), there were increased risk in one or more of the low SES groups (p<0.05). The best predictor was parental occupational class (Swedish socioeconomic classification index) for elevated blood pressure (area under the receiver operating characteristic (ROC) curve 0.623), maternal educational level for overweight (area under the ROC curve 0.641) and blue-collar city of residence for low HDL (area under the ROC curve 0.641). SES-related differences in overweight/obesity were found at age 2, 5 and 12 and for obesity at age 2, 5, 8 and 12 years (all p<0.05).
Even in a welfare state like Sweden, SES inequalities in cardiovascular risks are evident already in childhood and adolescence. Intervention programmes to reduce cardiovascular risk based on social inequality should start early in life.
研究社会经济地位（SES）是否可预测瑞典青少年的心血管危险因素。确定对每种心血管危险因素发展最重要的 SES 变量。研究超重和肥胖的 SES 不平等发生在什么年龄。
前瞻性出生队列的纵向随访。
所有东南瑞典婴儿（ABIS）研究包括 1997 年 10 月至 1999 年 10 月在瑞典东南部五个县出生的儿童的数据。
来自该地区三个主要城市的区域性 ABIS 研究亚样本，年龄为 16-18 岁的 298 名青少年，以及整个 ABIS 队列在 2、5、8 和 12 岁时超重和肥胖状态的前瞻性数据（n=2998-7925）。
对于四个心血管风险结果中的三个（高血压、超重/肥胖、低高密度脂蛋白胆固醇（HDL）或低高密度脂蛋白胆固醇边缘升高），一个或多个低 SES 组的风险增加（p<0.05）。最佳预测指标是父母职业阶层（瑞典社会经济分类指数）对高血压（ROC 曲线下面积 0.623）、母亲教育程度对超重（ROC 曲线下面积 0.641）和蓝领居住城市对低 HDL（ROC 曲线下面积 0.641）。在 2、5 和 12 岁时发现 SES 相关的超重/肥胖差异，在 2、5、8 和 12 岁时发现肥胖差异（均 p<0.05）。
即使在像瑞典这样的福利国家，心血管风险的 SES 不平等在儿童和青少年时期已经很明显。基于社会不平等的减少心血管风险的干预计划应尽早开始。
