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      Lifecourse socioeconomic trajectories and C-reactive protein levels in young adults: Findings from a Brazilian birth cohort

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          Abstract

          Socioeconomic factors are associated with cardiovascular disease. C-reactive protein (CRP) is increasingly implicated as a candidate linking conventional risk factors and atherosclerosis. The impact of early- and later-life socioeconomic status (SES) on CRP levels has not been widely investigated and a handful of studies from high-income countries are inconsistent. We set out to examine the associations between lifecourse socioeconomic indicators (family income at birth, maternal education, family income at age 23 and own education) on CRP levels in young adults belonging to the 1982 Pelotas (Brazil) Birth Cohort Study ( n = 5914). Early-life SES showed significant and graded associations with CRP levels at age 23 independently of later SES. For example, men with higher family income at birth showed higher CRP levels at age 23 (p = 0.001 for trend) and women with less educated mothers showed higher CRP levels (p = 0.01 for trend). Notably, differential directions of association between SES indicators and CRP levels between men and women were found. When adjusted for SES at age 23, men with the lowest family income at birth showed 42% lower CRP levels when compared to men in the highest family income group (−42; 95% CI: -60,-16). In contrast women born to the least educated mothers had the highest CRP levels (35; 95% CI -2, 86). In both sexes, adiposity accounted for the overwhelming majority of the associations between SES and CRP levels. Sex and gender roles specific to middle-income countries, socio-cultural and environmental conditions that may impact adiposity, and the level of epidemiological transition may be key factors that are linked to the associations between lifecourse SES and CRP levels. Public health strategies aimed at decreasing the burden of cardiovascular disease in middle-income settings, in addition to highlighting the risks associated with adult obesity, should not overlook the wide-ranging impacts of lifecourse social determinants.

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          Most cited references47

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          C-reactive protein: a critical update.

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            Socioeconomic status and obesity: a review of the literature.

            A review of 144 published studies of the relationship between socioeconomic status (SES) and obesity reveals a strong inverse relationship among women in developed societies. The relationship is inconsistent for men and children in developed societies. In developing societies, however, a strong direct relationship exists between SES and obesity among men, women, and children. A review of social attitudes toward obesity and thinness reveals values congruent with the distribution of obesity by SES in different societies. Several variables may mediate the influence of attitudes toward obesity and thinness among women in developed societies that result in the inverse relationship between SES and obesity. They include dietary restraint, physical activity, social mobility, and inheritance.
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              Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo.

              We measured arterio-venous differences in concentrations of tumor necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6) across a sc adipose tissue bed in the postabsorptive state in 39 subjects [22 women and 17 men; median age, 36 yr (interquartile range, 26-48 yr); body mass index, 31.8 kg/m2 (range, 22.3- 38.7 kg/m2); percent body fat, 28.7% (range, 17.6-50.7%)]. A subgroup of 8 subjects had arteriovenous differences measured across forearm muscle. Thirty subjects were studied from late morning to early evening; 19 ate a high carbohydrate meal around 1300 h, and 11 continued to fast. We found a greater than 2-fold increase in IL-6 concentrations across the adipose tissue bed [arterial, 2.27 pg/mL (range, 1.42-3.53 pg/mL); venous, 6.71 pg/mL (range, 3.36-9.62 pg/mL); P < 0.001], but not across forearm muscle. Arterial plasma concentrations of IL-6 correlated significantly with body mass index (Spearman's r = 0.48; P < 0.01) and percent body fat (Spearman's r = 0.49; P < 0.01). Subcutaneous adipose tissue IL-6 production increased by the early evening (1800-1900 h) in both subjects who had extended their fasting and those who had eaten. Neither deep forearm nor sc adipose tissue consistently released TNF alpha [across adipose tissue: arterial, 1.83 pg/mL (range, 1.36-2.34 pg/mL); venous, 1.85 pg/mL (range, 1.44-2.53 pg/mL); P = NS: across forearm muscle: arterial, 1.22 pg/mL (range, 0.74-2.76 pg/mL); venous, 0.99 pg/mL (range, 0.69-1.70 pg/mL); P = NS]. Although both IL-6 and TNF alpha are expressed by adipose tissue, our results show that there are important differences in their systemic release. TNF alpha is not released by this sc depot. In contrast, IL-6 is released from the depot and is thereby able to signal systemically.
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                Author and article information

                Journal
                Soc Sci Med
                Soc Sci Med
                Social Science & Medicine (1982)
                Pergamon
                0277-9536
                1873-5347
                April 2010
                April 2010
                : 70
                : 8
                : 1229-1236
                Affiliations
                [a ]Food Science and Nutrition, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA 93407, USA
                [b ]Federal University of Pelotas, Pelotas, Brazil
                Author notes
                []Corresponding author. Tel.: +1 805 756 6183; fax: +1 805 756 1146. anazmi@ 123456gmail.com
                Article
                SSM7162
                10.1016/j.socscimed.2009.12.014
                2877874
                20137842
                6ba180bc-158a-4ba9-859f-50b2cb7289bb
                © 2010 Elsevier Ltd.

                This document may be redistributed and reused, subject to certain conditions.

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                Health & Social care
                cardiovascular disease,lifecourse studies,gender,brazil,cohort studies,c-reactive protein,socioeconomic factors,inflammation

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