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

ArticleinAnnals of Epidemiology 17(10):782-90 · October 2007with17 Reads
DOI: 10.1016/j.annepidem.2007.05.003 · Source: PubMed
Abstract
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.
    • "In recent years, adverse conditions such as economic hardship, low education, and community disadvantage have been linked to biomarkers of inflammation and metabolic dysregulation, and to various chronic and age-related diseases such as type 2 diabetes, coronary heart disease, stroke, and dementia (Gruenewald et al., 2009; Hemingway et al., 2003; Koster et al., 2006; Loucks et al., 2007 Loucks et al., , 2010). This body of research suggests that exposure to chronic stress, especially the challenges and adversities associated with low socio-economic status (SES), can foster premature biological aging. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Past research has linked low socio-economic status (SES) to inflammation, metabolic dysregulation, and various chronic and age-related diseases such as type 2 diabetes, coronary heart disease, stroke, and dementia. These studies suggest that the challenges and adversities associated with low SES may result in premature aging and increased risk of morbidity and mortality. Objective: Building upon this research, the present study investigates various avenues whereby low income might accelerate biological aging. Methods: Structural equation modeling and longitudinal data from a sample of 100 Black, middle-aged women residing in the United States was used to investigate the effect of income on a recently developed epigenetic measure of biological aging. This measure can be used as a “biological clock” to assess, at any point during adulthood, the extent to which an individual is experiencing accelerated or decelerated biological aging. Results: Low income displayed a robust association with accelerated aging that was unaffected after controlling for other SES-related factors such as education, marital status, and childhood adversity. Further, our analyses indicated that the association between income and biological aging was not explained by health-related behaviors such as diet, exercise, smoking, alcohol consumption, or having health insurance. Rather, in large measure, it was financial pressure (difficulty paying bills, buying necessities, or meeting daily expenses) that accounted for the association between low income and accelerated aging. Conclusions: These findings support the view that chronic financial pressures associated with low income exert a weathering effect that results in premature aging.
    Full-text · Article · Jan 2016
    • "No such relationship was observed in men. A differential relationship of education with components of the metabolic syndrome across the genders has been observed in other investi- gations363738, but its causes are not known. HIV and TB infection are both commonly associated with weight loss. "
    [Show abstract] [Hide abstract] ABSTRACT: Beyond changing dietary patterns, there is a paucity of data to fully explain the high prevalence of obesity and hypertension in urban African populations. The aim of this study was to determine whether other environmental factors (including sleep duration, smoking and physical activity) are related to body anthropometry and blood pressure (BP). Data were collected on 1311 subjects, attending two primary health care clinics in Soweto, South Africa. Questionnaires were used to obtain data on education, employment, exercise, smoking and sleep duration. Anthropometric and BP measurements were taken. Subjects comprised 862 women (mean age 41 ± 16 years and mean BMI 29.9 ± 9.2 kg/m2) and 449 men (38 ± 14 years and 24.8 ± 8.3 kg/m2). In females, ANOVA showed that former smokers had a higher BMI (p<0.001) than current smokers, while exposure to second hand smoking was associated with a lower BMI (p<0.001) in both genders. Regression analyses demonstrated that longer sleep duration was associated with a lower BMI (p<0.05) in older females only, and not in males, whilst in males napping during the day for > 30 minutes was related to a lower BMI (β = -0.04, p<0.01) and waist circumference (β = -0.03, p<0.001). Within males, napping for >30 minutes/day was related to lower systolic (β = -0.02, p<0.05) and lower diastolic BP (β = -0.02, p = 0.05). Longer night time sleep duration was associated with higher diastolic (β = 0.005, p<0.01) and systolic BP (β = 0.003, p<0.05) in females. No health benefits were noted for physical activity. These data suggest that environmental factors rarely collected in African populations are related, in gender-specific ways, to body anthropometry and blood pressure. Further research is required to fully elucidate these associations and how they might be translated into public health programs to combat high levels of obesity and hypertension.
    Full-text · Article · Oct 2015
    • "Of both ethnic groups, women with low SES in childhood, early adulthood, middle adulthood, or cumulatively, were more likely to develop the syndrome than women with high SES (Chichlowska et al., 2009). Similarly, Loucks, Magnusson et al. (2007) found women aged 25–65 with income below the poverty line were more likely to develop the syndrome than women with higher income ratios even after adjusting for age, race/ethnicity, and menopause status. Interestingly, income and education were not associated with the syndrome for males, or female adolescents and older adults (age > 65 years). "
    [Show abstract] [Hide abstract] ABSTRACT: Management of metabolic syndrome (MetS), a group of disease processes that involves numerous body systems, is a complex combination of pharmacologic and nonpharmacologic modalities using current evidence-based guidelines. A case of an Asian-American adult with MetS is presented to highlight the increasing prevalence of this syndrome in Asian Americans compared to other racial groups.
    Full-text · Article · Sep 2014
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