Association of Socioeconomic Status Measured by Education and Risk Factors for Carotid Atherosclerosis: Cross-sectional Study

AIM: To investigate the association between socioeconomic status and metabolic syndrome, lifestyle, clinical and biochemical characteristics, and inflammatory markers as risk factors for carotid atherosclerotic disease. METHODS: This cross-sectional study, involving 657 consecutive patients with verified carotid atherosclerotic disease, was performed in Belgrade, Serbia, during the period 2006-2007. Formal education level was used as a proxy for socioeconomic status. Anthropometric parameters and data on cardiovascular risk factors were analyzed in participants with different levels of education--low (< or = primary school), medium (secondary school), and high (university education). In the analysis, univariate and multivariate logistic regressions were used. RESULTS: Multivariate analysis showed that low education was significantly positively associated with female sex (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.45-3.81), increased triglycerides (OR, 1.79; 95% CI, 1.12-2.78), increased high-sensitivity C-reactive protein (hsCRP) (OR, 3.53; 95% CI, 2.17-5.88), and physical inactivity (OR, 4.24; 95% CI, 1.82-9.86) and negatively associated with former smoking (OR, 0.42; 95% CI, 0.23-0.75). Medium education was significantly positively associated with increased triglycerides (OR, 1.73; 95% CI, 1.14-2.62) and increased hsCRP (OR, 2.17; 95% CI, 1.37-3.41), and negatively with age (OR, 0.97; 95% CI, 0.94-0.99). CONCLUSION: Increased triglycerides and hsCRP in people with low and medium education, and high prevalence of metabolic syndrome, its components and inflammatory markers in all study participants, suggest that regular health check-up, especially for those with lower education, may be useful in early detection and treatment of any abnormality that can be associated with cardiovascular disease.