Socioeconomic Position and the Metabolic Syndrome in Early, Middle, and Late Life: Evidence from NHANES 1999-2002

Department of Psychiatry, McGill University, Montréal, Quebec, Canada
Annals of Epidemiology (Impact Factor: 2). 10/2007; 17(10):782-90. DOI: 10.1016/j.annepidem.2007.05.003
Source: PubMed


To evaluate whether there is an association between socioeconomic position (SEP) and the metabolic syndrome at various ages, including adolescent, middle-aged and older participants in gender-specific analyses.
Participants were from the 1999-2002 National Health and Nutrition Examination Survey. SEP was measured by income and years of education. Metabolic syndrome was measured in adults using the American Heart Association guidelines and in adolescents using methods based on national reference data. Cross-sectional multivariable-adjusted logistic regression analyses were performed.
In women aged 25 to 45 and 46 to 65 years, income below the poverty line (poverty income ratio [PIR] less than one) was associated with higher odds of metabolic syndrome compared with PIR greater than 3 (odds ratio [OR] = 4.90; 95% confidence interval (CI) = 2.24, 10.71, and OR = 2.54; CI = 1.38, 4.67, for the respective age groups) after adjustment for age, race/ethnicity, and menopause. Similar findings were observed for educational attainment. In adolescents, older adults (aged >65 years), and males, income and education were not related to the metabolic syndrome.
This report demonstrates that SEP is associated with the metabolic syndrome in females aged 25 to 65 years and is less strongly associated in males, adolescents, or older participants. These findings provide physiologic mechanistic evidence linking SEP to risk for coronary heart disease.

4 Reads
  • Source
    • "Previous studies investigating this association have been inconclusive. Several have reported that low parental education and occupational status increase MetS risk,14,15,16) but the opposite results have also been reported.17) In addition, culture significantly affects attitudes toward child-rearing.18) "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Childhood socioeconomic status (SES) is known to affect cardio-metabolic disease risk. However, the relationship between childhood SES and metabolic syndrome (MetS) remains uncertain. Therefore, we investigated the relationship between childhood SES, as measured by maternal education and occupational status and adult-onset MetS in the Korean population. Methods We examined the association between childhood SES, as measured by maternal education level and occupational status during an individual's childhood, and MetS in Korean adults aged 20 to 79 years who participated in the 2007-2009 Korean National Health Examination and Nutrition Survey. The components of MetS, including waist circumference, fasting glucose, lipid profiles, and blood pressure, were measured. Adjusted odds ratios (ORs) for MetS were calculated using multiple logistic regression models. Results Significant differences in the association between maternal education level, occupational status, and MetS were found between males and females. In females, the adjusted MetS OR for the highest maternal education quartile relative to the lowest quartile was 0.46 (0.21-0.99). Similarly, in females, the adjusted OR for individuals whose mothers worked when they were children relative to those whose mothers did not work was 1.23 (1.04-1.44). In males, no significant associations between maternal education, maternal occupational status, and MetS were found. Conclusion We found independent, positive associations between maternal education and occupational status and MetS in Korean females. These findings suggest that public health education targeting MetS prevention should be considered, especially among children with less opportunity for maternal support.
    Korean Journal of Family Medicine 07/2014; 35(4):207-15. DOI:10.4082/kjfm.2014.35.4.207
  • Source
    • "Gender differences were observed, where in females the SRI was associated with systolic blood pressure, HDL cholesterol, waist circumference, BMI and diabetes, while in males the SRI was associated with HDL cholesterol and diabetes. Similar gender differences have been seen in the education-health literature where associations of education with CHD, diabetes and metabolic syndrome are often stronger in females than males [18, 94–97]. Potential mechanisms for gender differences include obesity-related effects on social mobility and greater concurrent psychosocial risk for low socioeconomic position women than men. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Social and behavioral risk markers (e.g., physical activity, diet, smoking, and socioeconomic position) cluster; however, little is known whether clustering is associated with coronary heart disease (CHD) risk. Objectives were to determine if sociobehavioral clustering is associated with biological CHD risk factors (total cholesterol, HDL cholesterol, systolic blood pressure, body mass index, waist circumference, and diabetes) and whether associations are independent of individual clustering components. Methods: Participants included 4,305 males and 4,673 females aged ≥ 20 years from NHANES 2001-2004. Sociobehavioral Risk Marker Index (SRI) included a summary score of physical activity, fruit/vegetable consumption, smoking, and educational attainment. Regression analyses evaluated associations of SRI with aforementioned biological CHD risk factors. Receiver operator curve analyses assessed independent predictive ability of SRI. Results: Healthful clustering (SRI = 0) was associated with improved biological CHD risk factor levels in 5 of 6 risk factors in females and 2 of 6 risk factors in males. Adding SRI to models containing age, race, and individual SRI components did not improve C-statistics. Conclusions: Findings suggest that healthful sociobehavioral risk marker clustering is associated with favorable CHD risk factor levels, particularly in females. These findings should inform social ecological interventions that consider health impacts of addressing social and behavioral risk factors.
    02/2014; 2014:389853. DOI:10.1155/2014/389853
  • Source
    • "The subgroups of non-manual workers including “managers”, “professional and related” workers, and “clerks” had a higher level of education and household income than the manual working groups in both the male and female workers. Several studies have shown an inverse association between socioeconomic status and the metabolic syndrome in women, but no association in men [16-18]. However, a recent study of the Korean population using 2007–2008 KNHANES data has reported that socioeconomic status (SES) had a positive association with the metabolic syndrome for men and an inverse association for women [19]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of the metabolic syndrome has increased rapidly in South Korea over the past 10 years. However, the occurrence of the metabolic syndrome in workers grouped according to the specific type of work is not well understood in Korea. In this study, we assessed the differences in the prevalence of the metabolic syndrome by occupational group and evaluated the risk of the metabolic syndrome among occupational groups. From the Fifth Korean National Health and Nutrition Examination Survey (2010), 3,303 employed participants were included in this study. The unadjusted and age-adjusted prevalences of the metabolic syndrome were estimated and multiple logistic regression analysis was conducted using the presence of the metabolic syndrome as a dependent variable, and adjusting for age, education level, household income, drinking behavior, smoking status, physical activity, work hours, and work scheduling pattern. Among male workers, non-manual workers had the greatest age-adjusted prevalence (26.4%, 95% CI: 22.3-30.5%) among the occupational groups. In a logistic regression analysis, male manual workers had a significantly lower odds ratio for the metabolic syndrome relative to non-manual workers (0.59, 95% CI: 0.41-0.85). Our study demonstrated differences in the prevalence of the metabolic syndrome by occupational group and identified the greatest risk for the metabolic syndrome in male non-manual workers.
    08/2013; 25(1):13. DOI:10.1186/2052-4374-25-13
Show more

Similar Publications