Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Breast Cancer Res Treat. 2023 Jun;199(3):479-487. doi: 10.1007/s10549-023-06949-5. Epub 2023 Apr 23.
To evaluate the association of subjective social status (SSS) with metabolic syndrome (MetS) severity and its potential contribution to racial health disparities in women with breast cancer.
Multicenter cross-sectional study (10 US hospitals) in women (n = 1206) with primary diagnosis of invasive breast cancer received during Mar/2013-Feb/2020. Participants, self-identified as non-Hispanic White or Black, underwent physical and laboratory examinations and survey questions assessing socioeconomic parameters, medical history, and behavioral risks. SSS was measured with the 10-rung MacArthur scale. MetS severity was measured with a validated Z-Score. Generalized linear mixed modeling was used to analyze the associations. Missing data were handled using multiple imputation.
Average age was 58 years. On average, the SSS of Black women, given equivalent level of income and education, was lower than the SSS of White women: 6.6 (6.1-7.0) vs 7.7 (7.54-7.79) among college graduates and 6.8 (6.4-7.2) vs 7.6 (7.5-7.8) among women in the high-income category (> $75,000). In multivariable analysis, after controlling for age, income, education, diet, and physical activity, increasing SSS was associated with a decrease in MetS-Z score, - 0.10 (- 0.16 to - 0.04) per every 2 rung increase in the MacArthur scale.
Black women with breast cancer rank their SSS lower than White women with breast cancer do at each level of income and education. As SSS is strongly associated with MetS severity these results identify potentially modifiable factors that contribute to racial disparities.
评估主观社会地位（SSS）与代谢综合征（MetS）严重程度的相关性，及其对乳腺癌女性中种族健康差异的潜在贡献。
这是一项在美国 10 家医院进行的多中心横断面研究，共纳入了 1206 名患有原发性浸润性乳腺癌的女性。参与者自我认定为非西班牙裔白种人或黑种人，接受了身体和实验室检查以及问卷调查，内容包括社会经济参数、病史和行为风险。SSS 采用 10 级麦克阿瑟量表进行评估。MetS 严重程度采用已验证的 Z 评分进行评估。采用广义线性混合模型分析相关性。使用多重插补处理缺失数据。
平均年龄为 58 岁。平均而言，在收入和教育水平相当的情况下，黑种女性的 SSS 低于白种女性：大学毕业者的 SSS 分别为 6.6（6.1-7.0）和 7.7（7.54-7.79），高收入者（>75000 美元）的 SSS 分别为 6.8（6.4-7.2）和 7.6（7.5-7.8）。多变量分析显示，在校正年龄、收入、教育、饮食和体力活动后，SSS 每增加 2 级，MetS-Z 评分降低 0.10（-0.16 至-0.04）。
在每个收入和教育水平，患有乳腺癌的黑种女性对 SSS 的评分均低于白种女性。由于 SSS 与 MetS 严重程度密切相关，因此这些结果确定了可能导致种族差异的可调节因素。
