University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, the Netherlands; Netherlands Interdisciplinary Demographic Institute, PO Box 11650, 2502 AR The Hague, the Netherlands; Vrije Universiteit Amsterdam, Department of Sociology, De Boelelaan 1081, 1081 HV Amsterdam, the Netherlands.
Prev Med. 2021 Jul;148:106537. doi: 10.1016/j.ypmed.2021.106537. Epub 2021 Mar 31.
The incidence of metabolic syndrome (MetS) strongly varies by socioeconomic position (SEP), but little is known about the mediating role of health behaviours in this association. This study examines the associations between the SEP measures, education, income and occupational prestige, and incident MetS and whether the associations are mediated by health behaviours, including physical activity, smoking, alcohol intake and diet quality.
A subsample (n = 85,910) of the adult Lifelines Cohort Study without MetS at baseline was used. MetS was measured at the second assessment (median follow-up time 3.8 years) defined according to the NCEP-ATPIII criteria. Direct associations between SEP, health behaviours and incident MetS were estimated using multivariable logistic regression analyses. The mediating percentages of health behaviours explaining the associations between SEP and incident MetS were estimated using the Karlson-Holm-Breen method. Analyses were independent of age, sex, the other SEP measures and follow-up time.
Education and occupational prestige were inversely associated with MetS. Income was not associated with MetS. Health behaviours explained only partly (13.8%) the association between education and MetS, with smoking as the strongest mediating factor (8.8%). Health behaviours played also a minor role (2.7%) in explaining occupational MetS differences, with physical activity as the strongest suppressing factor (-9.4%).
Individuals with more years of education or a higher occupational prestige had a lower risk to develop MetS. This was mainly because of non-smoking, less excessive alcohol intake and a higher diet quality. However, individuals with a higher SEP were more often physically inactive.
代谢综合征（MetS）的发病率因社会经济地位（SEP）而有很大差异，但人们对健康行为在这种关联中的中介作用知之甚少。本研究探讨了 SEP 衡量指标（教育、收入和职业声望）与代谢综合征发病之间的关联，以及这些关联是否通过健康行为（包括体力活动、吸烟、饮酒和饮食质量）来介导。
本研究使用成人生命线队列研究的亚样本（n=85910），这些人在基线时没有代谢综合征。代谢综合征是根据 NCEP-ATPIII 标准在第二次评估时测量的（中位随访时间 3.8 年）。使用多变量逻辑回归分析估计 SEP、健康行为与代谢综合征发病之间的直接关联。使用 Karlson-Holm-Breen 方法估计健康行为解释 SEP 与代谢综合征发病之间关联的中介百分比。分析独立于年龄、性别、其他 SEP 衡量指标和随访时间。
教育和职业声望与代谢综合征呈负相关。收入与代谢综合征无关。健康行为仅部分（13.8%）解释了教育与代谢综合征之间的关联，其中吸烟是最强的中介因素（8.8%）。健康行为在解释职业代谢综合征差异方面也只起次要作用（2.7%），其中体力活动是最强的抑制因素（-9.4%）。
受教育年限较长或职业声望较高的个体发生代谢综合征的风险较低。这主要是由于不吸烟、较少过度饮酒和较高的饮食质量。然而，社会经济地位较高的个体往往缺乏体力活动。
