Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, P.R. China.
Department of Pediatrics, The Second Affiliated Hospitical of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, P.R. China.
BMC Public Health. 2023 Oct 9;23(1):1955. doi: 10.1186/s12889-023-16881-4.
The social disparities in obesity may originate in early life or in adulthood, and the associations of socioeconomic position (SEP) with obesity could alter over time. It is unclear how lifetime-specific and life-course SEP influence adult obesity development in China.
Based on the China Health and Nutrition Survey (CHNS), three SEP-related indicators, including the father's occupational position and the participant's education and occupational position, were obtained. The life-course socioeconomic changes and a cumulative SEP score were established to represent the life-course SEP of the participants in the study. The growth mixture modeling was used to identify BMI trajectories in adulthood. Multinomial logistic regression was adopted to assess the associations between SEP and adult BMI trajectories.
A total of 3,138 participants were included in the study. A positive correlation was found between the paternal occupational position, the participants' occupational position, education, and obesity in males, whereas an inverse correlation was observed among females. Males who experienced social upward mobility or remained stable high SEP during the follow-up had 2.31 and 2.52-fold risks of progressive obesity compared to those with a stable-low SEP. Among females, stable high SEP in both childhood and adulthood was associated with lower risks of progressive obesity (OR = 0.63, 95% CI: 0.43-0.94). Higher risks of obesity were associated with the life-course cumulative SEP score among males, while the opposite relationship was observed among females.
The associations between life-course SEP and BMI development trajectories differed significantly by gender. Special emphasis should be placed on males experiencing upward and stable high socioeconomic change.
肥胖的社会差异可能源于生命早期或成年期，社会经济地位（SEP）与肥胖的关联可能随时间而改变。目前尚不清楚特定生命周期和生命历程中的 SEP 如何影响中国成年人肥胖的发展。
基于中国健康与营养调查（CHNS），获取了 3 个与 SEP 相关的指标，包括父亲的职业地位和参与者的教育和职业地位。建立了生命历程社会经济变化和累积 SEP 评分，以代表研究参与者的生命历程 SEP。采用增长混合建模来识别成年期 BMI 轨迹。采用多分类逻辑回归来评估 SEP 与成年 BMI 轨迹之间的关联。
共有 3138 名参与者纳入本研究。在男性中，父亲的职业地位、参与者的职业地位、教育和肥胖呈正相关，而在女性中则呈负相关。在随访期间经历社会向上流动或保持稳定高 SEP 的男性，与具有稳定低 SEP 的男性相比，进展性肥胖的风险分别增加了 2.31 倍和 2.52 倍。在女性中，童年和成年时期稳定的高 SEP 与进展性肥胖的风险降低相关（OR=0.63，95%CI：0.43-0.94）。男性的生命历程累积 SEP 评分与肥胖风险相关，而女性则呈相反关系。
生命历程 SEP 与 BMI 发展轨迹之间的关联在性别上存在显著差异。应特别关注经历向上和稳定高社会经济变化的男性。
