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)

View/ Open
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
Schmidt, Maria Inês
Barreto, Sandhi Maria
Note: Order does not necessarily reflect citation order of authors.
Published Version
https://doi.org/10.1371/journal.pone.0108426Metadata
Show full item recordCitation
Camelo, L. V., L. Giatti, J. A. B. Neves, P. A. Lotufo, I. M. Benseñor, D. Chor, R. H. Griep, et al. 2014. “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).” PLoS ONE 9 (10): e108426. doi:10.1371/journal.pone.0108426. http://dx.doi.org/10.1371/journal.pone.0108426.Abstract
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.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195589/pdf/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:13347426
Collections
- HMS Scholarly Articles [17852]
- SPH Scholarly Articles [6351]
Contact administrator regarding this item (to report mistakes or request changes)