O'Neill Kate N, Ahmed Minhal, O'Keeffe Linda M
School of Public Health, University College Cork, Cork, Ireland.
Harvard Medical School, Harvard University, Boston, MA, United States.
Eur J Public Health. 2025 Apr 1;35(2):249-255. doi: 10.1093/eurpub/ckaf022.
Evidence on when socioeconomic inequalities in conventional cardiometabolic risk factors emerge and how these change over time is sparse but important in identifying pathways to socioeconomic inequalities in cardiovascular disease (CVD). We examine socioeconomic inequalities in cardiometabolic risk factors trajectories across childhood and adolescence. Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991/1992. Socioeconomic position (SEP) was measured using maternal education from questionnaires at 32-weeks' gestation. Cardiometabolic risk factors measured from birth/mid-childhood to 18 years (y) included fat and lean mass (9-18 y), systolic and diastolic blood pressure (SBP, DBP), pulse rate and glucose (7-18 y), high-density lipoprotein cholesterol (HDL-c), non-HDL-c and triglycerides (birth-18y). Associations were examined using linear spline multilevel models. Among 6517-8952 participants with 11 948-42 607 repeated measures, socioeconomic inequalities in fat mass were evident at age 9 y and persisted throughout adolescence. By 18 y, fat mass was 12.32% [95% confidence interval (CI): 6.96, 17.68] lower among females and 7.94% (95% CI: 1.91, 13.97) lower among males with the highest SEP compared to the lowest. Socioeconomic inequalities in SBP and DBP were evident at 7 y, narrowed in early adolescence and re-emerged between 16 and 18 y, particularly among females. Socioeconomic inequalities in lipids emerged, among females only, between birth and 9 y in non-HDL-c, 7 and 18 y in HDL-c, and 9 and 18 y in triglycerides while inequalities in glucose emerged among males only between 15 and 18 y. Prevention targeting the early life course may be beneficial for reducing socioeconomic inequalities in CVD especially among females who have greater inequalities in cardiometabolic risk factors than males at the end of adolescence.
关于传统心脏代谢危险因素的社会经济不平等何时出现以及这些因素如何随时间变化的证据很少，但对于确定心血管疾病（CVD）社会经济不平等的途径很重要。我们研究了儿童期和青少年期心脏代谢危险因素轨迹中的社会经济不平等。数据来自1991/1992年出生的雅芳亲子纵向研究（ALSPAC）。社会经济地位（SEP）通过妊娠32周时问卷中的母亲教育程度来衡量。从出生/儿童中期到18岁测量的心脏代谢危险因素包括脂肪和瘦体重（9 - 18岁）、收缩压和舒张压（SBP、DBP）、脉搏率和血糖（7 - 18岁）、高密度脂蛋白胆固醇（HDL - c）、非HDL - c和甘油三酯（出生 - 18岁）。使用线性样条多级模型检验关联。在6517 - 8952名参与者中进行了11948 - 42607次重复测量，9岁时脂肪量的社会经济不平等明显，并在整个青春期持续存在。到18岁时，与最低SEP者相比，最高SEP的女性脂肪量低12.32% [95%置信区间（CI）：6.96，17.68]，男性低7.94%（95% CI：1.91，13.97）。SBP和DBP的社会经济不平等在7岁时明显，在青春期早期缩小，并在16至18岁之间再次出现，尤其是在女性中。脂质的社会经济不平等仅在女性中出现，非HDL - c在出生至9岁之间，HDL - c在7至18岁之间，甘油三酯在9至18岁之间，而葡萄糖的不平等仅在男性中在15至18岁之间出现。针对生命早期阶段的预防措施可能有助于减少CVD中的社会经济不平等，特别是在青春期结束时心脏代谢危险因素不平等比男性更大的女性中。
