Department of Epidemiology & Data Science, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
BMJ Open. 2024 Aug 28;14(8):e079987. doi: 10.1136/bmjopen-2023-079987.
The social environment (SE), that is, the social relationships and social context in which groups of people live and interact, is an understudied element of the broader living environment which impacts health. We aim to summarise the available evidence on the associations between SE and cardiometabolic disease (CMD) outcomes.
Systematic review and meta-analysis.
PubMed, Scopus and Web of Science Core Collection were searched from inception to 28 February 2024.
We included studies for which determinants were SE factors such as area-level deprivation and social network characteristics and outcomes were type 2 diabetes mellitus and cardiovascular diseases incidence and prevalence.
Titles and abstracts and full text were screened in duplicate. Data appraisal and extraction were based on the study protocol published in PROSPERO. Methodological quality was assessed with the Newcastle-Ottawa Scale. We synthesised the data through vote counting and meta-analyses.
From 10 143 records screened, 281 studies reporting 1108 relevant associations are included in this review. Of the 384 associations included in vote counting, 271 (71%) suggested that a worse SE is associated with a higher risk of CMD. 14 meta-analyses based on 180 associations indicated that worse SE was associated with increased odds of CMD outcomes, with 4 of them being statistically significant. For example, more economic and social disadvantage was associated with higher heart failure risk (OR 1.58, 95% CI 1.08 to 1.61; n=18; I=95%). With the exception of two meta-analyses for men, meta-analysed sex-specific associations consistently showed results in the same direction as the overall meta-analyses.
Worse SE seems to be associated with increased odds of CMD outcomes, although certain SE dimensions are underexplored in relation to CMD.
CRD42021223035.
社会环境（SE），即人们生活和互动的社会关系和社会背景，是更广泛的生活环境中一个研究不足的元素，它会影响健康。我们旨在总结现有关于 SE 与心血管代谢疾病（CMD）结局之间关联的证据。
系统评价和荟萃分析。
从创建到 2024 年 2 月 28 日，在 PubMed、Scopus 和 Web of Science Core Collection 中进行了搜索。
我们纳入了这样的研究，即其决定因素是 SE 因素，如区域贫困程度和社交网络特征，而结局是 2 型糖尿病和心血管疾病的发病率和患病率。
标题和摘要以及全文均经过双人筛选。数据评估和提取基于发表在 PROSPERO 上的研究方案进行。使用纽卡斯尔-渥太华量表评估方法学质量。我们通过投票计数和荟萃分析综合数据。
从筛选出的 10143 条记录中，有 281 项研究报告了 1108 项相关关联，纳入了本综述。在 384 项进行投票计数的关联中，有 271 项（71%）表明，较差的 SE 与更高的 CMD 风险相关。基于 180 项关联进行的 14 项荟萃分析表明，较差的 SE 与 CMD 结局的更高几率相关，其中 4 项具有统计学意义。例如，更多的经济和社会劣势与心力衰竭风险增加相关（OR 1.58，95%CI 1.08 至 1.61；n=18；I=95%）。除了两项针对男性的荟萃分析外，按性别分析的关联结果与整体荟萃分析的结果一致。
较差的 SE 似乎与 CMD 结局的更高几率相关，尽管某些 SE 维度与 CMD 之间的关联研究不足。
PROSPERO 注册号：CRD42021223035。
