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Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
BACKGROUND: Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP) and cardiovascular disease (CVD). We sought to examine the association between life course SEP and C-reactive protein (CRP) levels in adulthood, and...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195589/ https://www.ncbi.nlm.nih.gov/pubmed/25309988 http://dx.doi.org/10.1371/journal.pone.0108426 |
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author | Camelo, Lidyane V. Giatti, Luana Neves, Jorge Alexandre Barbosa Lotufo, Paulo A. Benseñor, Isabela M. Chor, Dóra Griep, Rosane Härter da Fonseca, Maria de Jesus Mendes Vidigal, Pedro Guatimosim Kawachi, Ichiro Schmidt, Maria Inês Barreto, Sandhi Maria |
author_facet | Camelo, Lidyane V. Giatti, Luana Neves, Jorge Alexandre Barbosa Lotufo, Paulo A. Benseñor, Isabela M. Chor, Dóra Griep, Rosane Härter da Fonseca, Maria de Jesus Mendes Vidigal, Pedro Guatimosim Kawachi, Ichiro Schmidt, Maria Inês Barreto, Sandhi Maria |
author_sort | Camelo, Lidyane V. |
collection | PubMed |
description | BACKGROUND: Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP) and cardiovascular disease (CVD). We sought to examine the association between life course SEP and C-reactive protein (CRP) levels in adulthood, and to evaluate the extent to which health-risk behaviors and metabolic alterations mediate this association. Additionally, we explored the possible modifying influence of gender. METHODS AND FINDINGS: Our analytical sample comprised 13,371 participants from ELSA-Brasil baseline, a multicenter prospective cohort study of civil servants. SEP during childhood, young adulthood, and adulthood were considered. The potential mediators between life course SEP and CRP included clusters of health-risk behaviors (smoking, low leisure time physical activity, excessive alcohol consumption), and metabolic alterations (obesity, hypertension, low HDL, hypertriglyceridemia, and diabetes). Linear regression models were performed and structural equation modeling was used to evaluate mediation. Although lower childhood SEP was associated with higher levels of CRP in adult life, this association was not independent of adulthood SEP. However, CRP increased linearly with increasing number of unfavorable social circumstances during the life course (p trend <0.001). The metabolic alterations were the most important mediator between cumulative SEP and CRP. This mediation path accounted for 49.5% of the total effect of cumulative SEP on CRP among women, but only 20.2% among men. In consequence, the portion of the total effect of cumulative SEP on CRP that was mediated by risk behaviors and metabolic alterations was higher among women (55.4%) than among men (36.8%). CONCLUSIONS: Cumulative SEP across life span was associated with elevated systemic inflammation in adulthood. Although health-risk behaviors and metabolic alterations were important mediators of this association, a sizable fraction of this association was not mediated by these factors, suggesting that other pathways might play a role, especially among men. |
format | Online Article Text |
id | pubmed-4195589 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-41955892014-10-15 Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Camelo, Lidyane V. Giatti, Luana Neves, Jorge Alexandre Barbosa Lotufo, Paulo A. Benseñor, Isabela M. Chor, Dóra Griep, Rosane Härter da Fonseca, Maria de Jesus Mendes Vidigal, Pedro Guatimosim Kawachi, Ichiro Schmidt, Maria Inês Barreto, Sandhi Maria PLoS One Research Article BACKGROUND: Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP) and cardiovascular disease (CVD). We sought to examine the association between life course SEP and C-reactive protein (CRP) levels in adulthood, and to evaluate the extent to which health-risk behaviors and metabolic alterations mediate this association. Additionally, we explored the possible modifying influence of gender. METHODS AND FINDINGS: Our analytical sample comprised 13,371 participants from ELSA-Brasil baseline, a multicenter prospective cohort study of civil servants. SEP during childhood, young adulthood, and adulthood were considered. The potential mediators between life course SEP and CRP included clusters of health-risk behaviors (smoking, low leisure time physical activity, excessive alcohol consumption), and metabolic alterations (obesity, hypertension, low HDL, hypertriglyceridemia, and diabetes). Linear regression models were performed and structural equation modeling was used to evaluate mediation. Although lower childhood SEP was associated with higher levels of CRP in adult life, this association was not independent of adulthood SEP. However, CRP increased linearly with increasing number of unfavorable social circumstances during the life course (p trend <0.001). The metabolic alterations were the most important mediator between cumulative SEP and CRP. This mediation path accounted for 49.5% of the total effect of cumulative SEP on CRP among women, but only 20.2% among men. In consequence, the portion of the total effect of cumulative SEP on CRP that was mediated by risk behaviors and metabolic alterations was higher among women (55.4%) than among men (36.8%). CONCLUSIONS: Cumulative SEP across life span was associated with elevated systemic inflammation in adulthood. Although health-risk behaviors and metabolic alterations were important mediators of this association, a sizable fraction of this association was not mediated by these factors, suggesting that other pathways might play a role, especially among men. Public Library of Science 2014-10-13 /pmc/articles/PMC4195589/ /pubmed/25309988 http://dx.doi.org/10.1371/journal.pone.0108426 Text en © 2014 Camelo et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Camelo, Lidyane V. Giatti, Luana Neves, Jorge Alexandre Barbosa Lotufo, Paulo A. Benseñor, Isabela M. Chor, Dóra Griep, Rosane Härter da Fonseca, Maria de Jesus Mendes Vidigal, Pedro Guatimosim Kawachi, Ichiro Schmidt, Maria Inês Barreto, Sandhi Maria Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) |
title | Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) |
title_full | Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) |
title_fullStr | Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) |
title_full_unstemmed | Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) |
title_short | Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) |
title_sort | life course socioeconomic position and c-reactive protein: mediating role of health-risk behaviors and metabolic alterations. the brazilian longitudinal study of adult health (elsa-brasil) |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195589/ https://www.ncbi.nlm.nih.gov/pubmed/25309988 http://dx.doi.org/10.1371/journal.pone.0108426 |
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