SOCIAL INEQUALITIES IN C-REACTIVE PROTEIN LEVELS IN ADULTS FROM THE BRAZILIAN LONGITUDINAL STUDY OF ADULT HEALTH (ELSA-BRASIL): A LIFE COURSE ANALYSIS

Camelo, Lidyane

SOCIAL INEQUALITIES IN C-REACTIVE PROTEIN LEVELS IN ADULTS FROM THE BRAZILIAN LONGITUDINAL STUDY OF ADULT HEALTH (ELSA-BRASIL): A LIFE COURSE ANALYSIS

Wednesday, 20 August 2014

Exhibit hall (Dena'ina Center)

Lidyane V Camelo, MPH , Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

Luana Giatti, PhD , Universidade Federal de Ouro Preto, Ouro Preto, Brazil

Paulo A Lotufo, PhD , Universidade de São Paulo, São Paulo, Brazil

Pedro G Vidigal, PhD , Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

Dora Chor, PhD , Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

Isabela Bensenor, PhD , Universidade de São Paulo, São Paulo, Brazil

Rosane H Griep, PhD , Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

Maria de Jesus d Fonseca, PhD , Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

Maria Inês A Schmidt, PhD , Federal University of Rio Grande do Sul, Porto Alegre, Brazil

Sandhi M Barreto, PhD , Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

INTRODUCTION: Chronic inflammation has been postulated to be one explanatory mechanism between socioeconomic position (SEP) and cardiovascular disease (CVD). We investigated the association between three life course SEP approaches (sensitive periods, accumulation of risk, and social mobility) and C-reactive protein (CRP) levels, as well as the possible modifying effect of gender.

METHODS: All ELSA-Brasil cohort members participated, except those with prevalent CVD and women using hormonal therapy (N=12,855 out of 15,105). Childhood SEP was determined by maternal education and leg length. Early adulthood and adulthood SEP were assessed by own education and per capita household income, respectively. A cumulative SEP score was calculated based on these variables and ranged from 0 (lowest risk) to 7 (highest risk). Socioeconomic trajectories from childhood to early adulthood were calculated by using maternal education and participants’ education.

RESULTS: Lower childhood SEP was associated with higher levels of CRP in adult life, independently of adulthood SEP. For instance, compared with participants with ≥11 years of maternal education, men and women whose mothers had 8-10 years of education presented higher CRP (β = 0.1209;95%CI:0.0444-0.1974 and β = 0.1032;95%CI:0.0267-0.1796, respectively). The higher the cumulative SEP, the higher the CRP levels in men (β = 0.0571;95%CI:0.0415-0.0726) and women (β = 0.0355;95%CI:0.0191-0.0519). Higher CRP levels was also found in those with “decreasing” social trajectories in men (β = 0.1479;95%CI:0.0634-0.2325) and women (β = 0.1237;95%CI:0.0391-0.2083) compared with participants with “high stable” social trajectories. The magnitudes of all associations were higher among women in the minimally adjusting models. However, after adjusting for proximal CVD risk factors the magnitude of the associations became higher among men. Obesity substantially lowered most of the association between SEP and CRP among women, whereas it made the magnitude of these associations increase among men.

CONCLUSIONS: These results support that exposure to unfavorable SEP throughout life might play a role in the causal pathway between SEP and chronic inflammation.