Department of Health Outcomes and Biomedical Informatics, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA.
Department of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, Mississippi, 39216, USA.
Psychoneuroendocrinology. 2020 Jul;117:104686. doi: 10.1016/j.psyneuen.2020.104686. Epub 2020 Apr 26.
To assess independent associations between objective socioeconomic status (OSS) and subjective social status (SSS) with metabolic syndrome (MetS) severity and indicators among African American (AA) adults in the Jackson Heart Study (JHS) at baseline (2000-2004) and eight-year follow-up (2009-2013).
Participants included 1724 AA adults from the JHS cohort (64.4 % women; mean age 53.4 ± 11.8). Associations of OSS (annual household income and school years completed) and SSS (measured with MacArthur Scales) with sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, alcohol consumption, and depressive symptoms) at baseline and eight-year follow-up.
Independent of OSS, demographic, psychosocial, and lifestyle factors, individuals with lower US-society SSS had more severe MetS at baseline. A significant interaction existed between sex and US-society SSS such that women with lower perceived social status had more severe MetS severity at baseline, and for every one unit increase in US-society SSS, MetS severity Z-score is estimated to decrease by 0.04. Components of MetS driving the relationship between US-society SSS and MetS severity at baseline were the inverse associations of SSS with glucose levels and the positive associations of SSS with HDL-C. Physical activity was independently associated with MetS severity at baseline, but not at eight-year follow-up.
Though subjective and objective measures of social status are independently associated with cardiometabolic risk factors and MetS severity among AA adults, SSS may be a stronger predictor of MetS severity than OSS, particularly among women. SSS should be considered in conjunction with OSS when exploring social determinants of cardiometabolic health.
评估客观社会经济地位（OSS）和主观社会地位（SSS）与非裔美国人（AA）成年人代谢综合征（MetS）严重程度和指标的独立关联，研究对象来自杰克逊心脏研究（JHS）的基线（2000-2004 年）和 8 年随访（2009-2013 年）。
JHS 队列纳入了 1724 名 AA 成年人（64.4%为女性；平均年龄 53.4±11.8 岁）。在基线和 8 年随访时，通过调整人口统计学和 MetS 风险因素（即营养、身体活动、吸烟状况、饮酒状况和抑郁症状），分析 OSS（年收入和完成学年数）和 SSS（使用麦克阿瑟量表测量）与按性别和种族/民族划分的 MetS 严重程度 Z 评分的关联。
在不考虑 OSS 的情况下，个体的社会地位感知越低，其在基线时的 MetS 严重程度越高。性别和美国社会 SSS 之间存在显著的交互作用，即感知社会地位较低的女性在基线时 MetS 严重程度更高，而美国社会 SSS 每增加一个单位，MetS 严重程度 Z 评分估计会降低 0.04。导致美国社会 SSS 与基线时 MetS 严重程度之间关系的 MetS 成分是 SSS 与血糖水平呈负相关，与 HDL-C 呈正相关。身体活动与基线时的 MetS 严重程度独立相关，但与 8 年随访时无关。
尽管主观和客观的社会地位测量与 AA 成年人的心血管代谢危险因素和 MetS 严重程度独立相关，但 SSS 可能比 OSS 更能预测 MetS 严重程度，尤其是在女性中。在探索心血管代谢健康的社会决定因素时，应同时考虑 SSS 和 OSS。
