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October 13, 2014PLoS ONEOpen Access

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)

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Key result

Cumulative socioeconomic disadvantage across the life span was linearly associated with elevated C-reactive protein levels in adulthood, with metabolic alterations mediating 49.5% of this effect in women and 20.2% in men.

Why the study?

Does lower cumulative socioeconomic position across the life course increase C-reactive protein levels in adulthood, and is this mediated by health-risk behaviors and metabolic alterations?

Population

13,371 civil servants from six Brazilian states participating in the ELSA-Brasil baseline cohort. Excluded…

Comparison

Lower cumulative life course socioeconomic… vs Higher cumulative life course socioeconomic…

Design

Cohort

Authors

LCLidyane do Valle CameloLGLuana GiattiJNJorge Alexandre Barbosa Neves

Discussion

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Overview

May warrant considering life-course disadvantage in inflammation risk assessment; leaves open causal effects and intervention targets.

Study Design

Type

Cross-Sectional (n=13,371)

Multicenter

Yes

Structured PICO

Does lower cumulative socioeconomic position across the life course increase C-reactive protein levels in adulthood, and is this mediated by health-risk behaviors and metabolic alterations?

P
Population
13,371 civil servants (aged 35-74, mean age 52 years, 6,654 men and 6,717 women) from six Brazilian states participating in the ELSA-Brasil baseline cohort. Excluded: women using hormonal contraceptive or replacement therapy, missing CRP values, or CRP below detection limit.
I
Intervention
Lower cumulative life course socioeconomic position (SEP) score (based on maternal education, participant's own education, and per capita household income)
C
Comparator
Higher cumulative life course socioeconomic position (SEP)
O
Outcome
C-reactive protein (CRP) levels in adulthoodsurrogate

Main Result

p-value: p=<0.001

Cumulative socioeconomic disadvantage across the lifespan is associated with higher systemic inflammation in adulthood, an effect that is partially mediated by metabolic alterations and health-risk behaviors, particularly in women.

Limitations

  • Used clusters of risk factors to analyze mediation, which may obscure the specific role of individual factors.
  • Stress was not included in the analysis and may be a relevant unmeasured pathway between socioeconomic position and CRP levels.

Cite This Study

Camelo et al. (2014) conducted a cross-sectional in Systemic Inflammation (n=13,371). Cumulative socioeconomic position (SEP) disadvantage vs. Higher socioeconomic position was evaluated on C-reactive protein (CRP) levels in adulthood (p=<0.001). Cumulative socioeconomic disadvantage across the life span was linearly associated with elevated C-reactive protein levels in adulthood, with metabolic alterations mediating 49.5% of this effect in women and 20.2% in men.

synapsesocial.com/papers/6a192a58ff42a97fac57ecbbhttps://doi.org/10.1371/journal.pone.0108426
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Socioeconomic position, health behaviors, and C-reactive protein: A moderated-mediation analysis.2010 · 62 citations
  2. 2When do social inequalities in C-reactive protein start? A life course perspective from conception to adulthood in the Cardiovascular Risk in Young Finns Study2007 · 49 citations
  3. 3Association between life-course socioeconomic position and inflammatory biomarkers in older age: a nationally representative cohort study in Taiwan2017 · 14 citations
  4. 4The Social Patterns of a Biological Risk Factor for Disease: Race, Gender, Socioeconomic Position, and C-reactive Protein2012 · 42 citations
  5. 5Cumulative life course and adult socioeconomic status and markers of inflammation in adulthood2008 · 135 citations