慢性炎症中社会经济不平等的早期起源:评估低出生体重和短母乳喂养的贡献。
Early origins of socioeconomic inequalities in chronic inflammation: Evaluating the contributions of low birth weight and short breastfeeding.
机构信息
Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA; Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA; Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, Ontario, M5G 1Z8, Canada.
Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA.
出版信息
Soc Sci Med. 2021 Jan;269:113592. doi: 10.1016/j.socscimed.2020.113592. Epub 2020 Dec 8.
The United States is characterized by persistent and widening social inequities in a wide range of adult health outcomes. A life course approach challenges us to consider if, and how, these inequities trace back to early life conditions, and chronic inflammation represents a potentially important mechanism through which early environments may have lasting effects on health in adulthood. Low birth weight (LBW) and shorter durations of breastfeeding both predict increased inflammation in adulthood, which is associated with increased risk for cardiovascular disease, metabolic syndrome, and all-cause mortality. Using data from a large representative sample of young adults in the US (National Longitudinal Study of Adolescent to Adult Health (Add Health)), we document the socioeconomic status (SES) gradient in chronic inflammation, as indicated by concentrations of C-reactive protein (CRP). Using a nested set of structural equation models and marginal standardization techniques, we investigate the extent to which this gradient is explained by patterns of LBW and breastfeeding in infancy. Findings reveal a particularly important role for breastfeeding duration: Based on model predictive margins, increasing breastfeeding duration to three or more months corresponds to a flattening of the SES gradient by 80%, and 83% when LBW is eliminated. This study expands current understandings of the consequential role of developmental environments for population health and for addressing health inequities in future generations.
美国的特点是在广泛的成人健康结果方面存在持久且不断扩大的社会不平等现象。生命历程方法挑战我们去思考这些不平等现象是否可以追溯到生命早期的条件,以及慢性炎症是否代表了一种潜在的重要机制,通过这种机制,早期环境可能对成年后的健康产生持久影响。低出生体重 (LBW) 和母乳喂养时间较短都预示着成年后炎症增加,这与心血管疾病、代谢综合征和全因死亡率的风险增加有关。本研究利用来自美国大量代表性年轻成年人的数据(青少年至成人健康纵向研究 (Add Health)),记录了慢性炎症(如 C 反应蛋白 (CRP) 浓度)方面的社会经济地位(SES)梯度。使用嵌套的结构方程模型和边际标准化技术,我们调查了这种梯度在多大程度上可以通过婴儿期的低出生体重和母乳喂养模式来解释。研究结果揭示了母乳喂养持续时间的特别重要作用:根据模型预测边际,将母乳喂养持续时间增加到三个月或更长时间,可使 SES 梯度变平 80%,而消除 LBW 则使 SES 梯度变平 83%。本研究扩展了对发展环境对人口健康和解决未来几代人健康不平等现象的重要作用的现有认识。
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