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年轻成年人的社会经济地位与心血管危险因素:巴西出生队列的横断面分析

Socioeconomic status and cardiovascular risk factors in young adults: a cross-sectional analysis of a Brazilian birth cohort.

作者信息

Silva Fernando Alberto Costa Cardoso da, Bragança Maylla Luanna Barbosa Martins, Bettiol Heloisa, Cardoso Viviane Cunha, Barbieri Marco Antonio, Silva Antônio Augusto Moura da

机构信息

Postgraduation Program of Collective Health, Department of Public Health, Universidade Federal do Maranhão - São Luís (MA), Brazil.

Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil.

出版信息

Rev Bras Epidemiol. 2020 Feb 21;23:e200001. doi: 10.1590/1980-549720200001. eCollection 2020.

Abstract

INTRODUCTION

In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial.

OBJECTIVE

To evaluate the association between family income and cardiovascular risk factors in young adults.

METHODS

A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeirão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. Income was assessed in multiples of the minimum wage. Simple Poisson regression models were used to estimate the prevalence ratios (PR) with robust estimation of the variance.

RESULTS

High-income women showed lower prevalences of low HDL-cholesterol (PR = 0.47), total obesity (PR = 0.22), abdominal obesity (PR = 0.28), high blood pressure (PR = 0.28), insulin resistance (PR = 0.57), sedentary lifestyle (PR = 0.47), metabolic syndrome (PR = 0.24), and high caloric intake (PR = 0.71) (p < 0.05). High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05). These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments.

CONCLUSION

Women were in the final phase of the epidemiologic transition, whereas men were in the middle phase.

摘要

引言

在高收入国家,社会经济地位高的人群心血管疾病风险较低。然而,在中低收入国家,结果存在争议。

目的

评估年轻成年人家庭收入与心血管危险因素之间的关联。

方法

对1978/79年在巴西里贝朗普雷图市启动的一个出生队列中的2063名个体在23/25岁时进行了评估。根据家庭收入评估心血管危险因素(高血压、久坐不动的生活方式、吸烟、低高密度脂蛋白(HDL)胆固醇、高低密度脂蛋白(LDL)胆固醇、高纤维蛋白原、胰岛素抵抗、糖尿病、腹部肥胖和全身肥胖以及代谢综合征)。收入以最低工资倍数进行评估。使用简单泊松回归模型估计患病率比(PR)并对方差进行稳健估计。

结果

高收入女性低HDL胆固醇(PR = 0.47)、全身肥胖(PR = 0.22)、腹部肥胖(PR = 0.28)、高血压(PR = 0.28)、胰岛素抵抗(PR = 0.57)、久坐不动的生活方式(PR = 0.47)、代谢综合征(PR = 0.24)和高热量摄入(PR = 0.71)的患病率较低(p < 0.05)。高收入男性低HDL胆固醇(PR = 0.73)和久坐不动(PR = 0.81)的患病率较低(p < 0.05)。这些结果可能是由于高收入女性更关注健康习惯,而家庭收入最低的女性获得卫生服务资源和治疗的可能性最小。

结论

女性处于流行病学转变的最后阶段,而男性处于中间阶段。

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