Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A & M University, Tallahassee, FL, USA.
Specialty Program in Geriatrics, Department of Family Medicine, School of Health, Gerontology and Geriatrics Research Group, Universidad del Valle, Cali, Colombia.
Nutr Metab Cardiovasc Dis. 2024 Jul;34(7):1751-1760. doi: 10.1016/j.numecd.2024.01.022. Epub 2024 Jan 26.
Social determinants of health (SDH) are critical in health outcomes. More insight is needed on the correlation between SDH and metabolic syndrome (MetS) in the aging population. This study assessed the association between SDH and MetS scores among older adults in Colombia.
This cross-sectional country-wide study includes a sample of 4085 adults aged ≥60 from the SABE Colombia Survey. MetS measurements were central obesity, hyperglycemia or diabetes, hypertriglyceridemia, arterial hypertension, and low HDL cholesterol (MetS score 0-5). SDH includes four levels: 1- general socioeconomic and environmental conditions; 2-social and community networks; 3- individual lifestyle; and 4-constitutional factors. In multivariate linear regression analysis, the SDH factors with greater effect sizes, calculated by Eta Squared, predicting higher MetS mean scores were women followed by low education, no alcohol intake, urban origin, and residing in unsafe neighborhoods. Two interactions: men, but not women, have lower MetS in safe neighborhoods compared to unsafe, and men, but not women, have lower MetS when having low education (0-5 years) compared to high (≥6).
Gender, education, alcohol intake, and origin have the greatest effect sizes on MetS. Education level and neighborhood safety modified the relationship between gender and MetS. Low-educated men or those residing in safe neighborhoods have lower MetS. Neighborhood environments and educational differences influencing MetS should be considered in future studies.
健康的社会决定因素（SDH）对健康结果至关重要。需要更多地了解老龄化人口中 SDH 与代谢综合征（MetS）之间的相关性。本研究评估了哥伦比亚老年人中 SDH 与 MetS 评分之间的关系。
这是一项横断面全国性研究，包括来自 SABE 哥伦比亚调查的 4085 名年龄≥60 岁的成年人样本。MetS 测量指标包括中心性肥胖、高血糖或糖尿病、高甘油三酯血症、动脉高血压和低 HDL 胆固醇（MetS 评分 0-5）。SDH 包括四个层面：1-一般社会经济和环境条件；2-社会和社区网络；3-个人生活方式；4-体质因素。在多元线性回归分析中，用 Eta 平方计算出的具有较大效应大小的 SDH 因素，预测更高的 MetS 平均评分，依次为女性、低教育程度、不饮酒、城市出身和居住在不安全社区。有两个相互作用：与不安全社区相比，男性（而不是女性）在安全社区中的 MetS 较低，与高（≥6 年）相比，低教育（0-5 年）的男性（而不是女性）的 MetS 较低。
性别、教育程度、饮酒和出身对 MetS 的影响最大。教育程度和社区安全状况改变了性别与 MetS 之间的关系。受教育程度低的男性或居住在安全社区的男性，MetS 水平较低。未来的研究应考虑环境和教育差异对 MetS 的影响。
