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Fazio E, Bionda A, Liotta L, Amato A, Chiofalo V, Crepaldi P, Satué K, Lopreiato V. Changes of acute-phase proteins, glucose, and lipid metabolism during pregnancy in lactating dairy cows. Arch Anim Breed 2022; 65:329-339. [PMID: 36267480 PMCID: PMC9562691 DOI: 10.5194/aab-65-329-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/31/2022] [Indexed: 09/28/2023] Open
Abstract
The study aimed to evaluate the effects of different stages of lactation (0 to > 300 d) and pregnancy (0 to > 180 d) on serum amyloid A (SAA), C-reactive protein (CRP), glucose, total cholesterol (TCho), and triglyceride (TG) concentrations in dairy cows of different breeds. Thus, 40 healthy multiparous cows (10 Holstein, 10 Simmental, 10 Brown, and 10 Modicana) were randomly selected, and blood samples were collected once every 60 d for 1 year. Overall, SAA and CRP serum concentrations progressively increased and became more variable along the lactation, peaking at > 240-300 d, and then decreased in the last period ( > 300 d). Along pregnancy, SAA and CRP initially increased, with the highest concentrations at > 60-120 d, and then decreased until the last phase of pregnancy ( > 180 d). However, lactation and gestation phases did not significantly affect SAA and CRP when all the cows were analyzed together. A significant and positive correlation was observed between SAA and CRP both along lactation ( r = 0.89 ; p < 0.0001 ) and pregnancy ( r = 0.91 ; p < 0.0001 ). Breeds only showed differences in CRP levels along gestation ( p = 0.0102 ), due to a peak registered at 0-60 d in Holstein cows. In pregnant cows, glucose was positively correlated with SAA ( r = 0.43 ; p = 0.0017 ) and CRP ( r = 0.42 ; p = 0.0019 ). Hence, these significant and positive relationships reflect the physiological adaptations of the dairy cows along both gestational and lactational dynamics, suggesting that these proteins may also be involved in non-pathological processes. In this perspective, this study established that the obtained response markedly varies among healthy individuals along lactation and gestation and thus that the physiological range of acute-phase proteins (APPs) is wide; this makes it difficult to use these proteins as a marker of different physiological reproductive and productive periods.
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Affiliation(s)
- Esterina Fazio
- Department of Veterinary Sciences, Messina University, Viale
Palatucci, 13, 98168, Messina, Italy
| | - Arianna Bionda
- Department of Veterinary Sciences, Messina University, Viale
Palatucci, 13, 98168, Messina, Italy
| | - Luigi Liotta
- Department of Veterinary Sciences, Messina University, Viale
Palatucci, 13, 98168, Messina, Italy
| | - Annalisa Amato
- Department of Veterinary Sciences, Messina University, Viale
Palatucci, 13, 98168, Messina, Italy
| | - Vincenzo Chiofalo
- Department of Veterinary Sciences, Messina University, Viale
Palatucci, 13, 98168, Messina, Italy
| | - Paola Crepaldi
- Department of Agricultural and Environmental Sciences, Milan
University, Via Celoria, 2, 20133, Milan, Italy
| | - Katiuska Satué
- Department of Animal Medicine and Surgery, Faculty of Veterinary
Medicine, CEU-Cardenal Herrera University, 46115, Valencia, Spain
| | - Vincenzo Lopreiato
- Department of Veterinary Sciences, Messina University, Viale
Palatucci, 13, 98168, Messina, Italy
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Further comment on articles pertaining to: "Homocysteine as a potential predictor of cardiovascular risk in patients with COVID-19". Med Hypotheses 2021; 155:110676. [PMID: 34555782 PMCID: PMC8418050 DOI: 10.1016/j.mehy.2021.110676] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/09/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022]
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Panagiotakos DB, Magriplis E, Zampelas A. The recalibrated HellenicSCORE based on newly derived risk factors from the Hellenic National Nutrition and Health Survey (HNNHS); the HellenicSCORE II. Hellenic J Cardiol 2020; 62:285-290. [PMID: 32311430 DOI: 10.1016/j.hjc.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Because of the increased burden of cardiovascular disease (CVD), country specific risk prediction models to forecast future CVD events and mortality are recommended, for primary prevention. The aim of this study was to recalibrate the HellenicSCORE, to accurately estimate the 10-year risk CVD mortality of Greek adults. METHODS Data from the Hellenic National Nutrition and Health Survey (HNNHS) were used (N = 1012; 37.9% males). Information on age, smoking, systolic blood pressure (SBP), and total blood cholesterol from adults >40 years of age were derived following validated health survey protocols. Individual scores were calculated using these data and beta-coefficients derived from ESC SCORE. RESULTS Both updated HellenicSCORE II charts had lower risk estimates compared to the older version and were closer to the ESC SCORE charts, particularly at the extremes. No significant age difference by sex was observed (mean 59.5 (SD 13.1) years in total) in the population. Women had a significant higher mean total cholesterol compared to men [212.9 (39.5) vs 204.6 (41.2) mg/dl, respectively; p = 0.0343], but smoking prevalence and mean SBP was significantly higher in men [p for all, <0.001]. The mean population HellenicSCORE II score level was between 5.6% (0.2) and 7.9% (3.2) depending on the chart used, with no significant sex differences. CONCLUSION Although the HellenicSCORE II charts were lower, the mean population score was moderately high. This is of great importance because according to ESC guidelines, lifestyle intervention, and drug treatment should be based on an individuals' total cardiovascular risk.
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Affiliation(s)
- Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Eleftheriou Venizelou 70, 176 76 Athens, Greece.
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
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Morris G, Berk M, Maes M, Carvalho AF, Puri BK. Socioeconomic Deprivation, Adverse Childhood Experiences and Medical Disorders in Adulthood: Mechanisms and Associations. Mol Neurobiol 2019; 56:5866-5890. [PMID: 30685844 PMCID: PMC6614134 DOI: 10.1007/s12035-019-1498-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 01/15/2019] [Indexed: 12/30/2022]
Abstract
Severe socioeconomic deprivation (SED) and adverse childhood experiences (ACE) are significantly associated with the development in adulthood of (i) enhanced inflammatory status and/or hypothalamic-pituitary-adrenal (HPA) axis dysfunction and (ii) neurological, neuroprogressive, inflammatory and autoimmune diseases. The mechanisms by which these associations take place are detailed. The two sets of consequences are themselves strongly associated, with the first set likely contributing to the second. Mechanisms enabling bidirectional communication between the immune system and the brain are described, including complex signalling pathways facilitated by factors at the level of immune cells. Also detailed are mechanisms underpinning the association between SED, ACE and the genesis of peripheral inflammation, including epigenetic changes to immune system-related gene expression. The duration and magnitude of inflammatory responses can be influenced by genetic factors, including single nucleotide polymorphisms, and by epigenetic factors, whereby pro-inflammatory cytokines, reactive oxygen species, reactive nitrogen species and nuclear factor-κB affect gene DNA methylation and histone acetylation and also induce several microRNAs including miR-155, miR-181b-1 and miR-146a. Adult HPA axis activity is regulated by (i) genetic factors, such as glucocorticoid receptor polymorphisms; (ii) epigenetic factors affecting glucocorticoid receptor function or expression, including the methylation status of alternative promoter regions of NR3C1 and the methylation of FKBP5 and HSD11β2; (iii) chronic inflammation and chronic nitrosative and oxidative stress. Finally, it is shown how severe psychological stress adversely affects mitochondrial structure and functioning and is associated with changes in brain mitochondrial DNA copy number and transcription; mitochondria can act as couriers of childhood stress into adulthood.
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Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - Basant K Puri
- Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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Page A, Lane A, Taylor R, Dobson A. Trends in socioeconomic inequalities in mortality from ischaemic heart disease and stroke in Australia, 1979–2006. Eur J Prev Cardiol 2011; 19:1281-9. [DOI: 10.1177/1741826711427505] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andrew Page
- School of Population Health, University of Queensland, Herston, Australia
| | - Amanda Lane
- School of Population Health, University of Queensland, Herston, Australia
| | - Richard Taylor
- School of Public Health and Community Medicine, University of New South Wales, Randwick, Australia
| | - Annette Dobson
- School of Population Health, University of Queensland, Herston, Australia
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Maternal warmth buffers the effects of low early-life socioeconomic status on pro-inflammatory signaling in adulthood. Mol Psychiatry 2011; 16:729-37. [PMID: 20479762 PMCID: PMC2925055 DOI: 10.1038/mp.2010.53] [Citation(s) in RCA: 222] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The notion that family support may buffer individuals under adversity from poor outcomes has been theorized to have important implications for mental and physical health, but little is known about the biological mechanisms that explain these links. We hypothesized that adults who grew up in low socioeconomic status (SES) households but who experienced high levels of maternal warmth would be protected from the pro-inflammatory states typically associated with low SES. A total of 53 healthy adults (aged 25-40 years) low in SES early in life were assessed on markers of immune activation and systemic inflammation. Genome-wide transcriptional profiling also was conducted. Low early-life SES individuals who had mothers, who expressed high warmth toward them, exhibited less Toll-like receptor-stimulated production of interleukin 6, and reduced bioinformatic indications of pro-inflammatory transcription factor activity (NF-κB) and immune activating transcription factor activity (AP-1) compared to those who were low in SES early in life but experienced low maternal warmth. To the extent that such effects are causal, they suggest the possibility that the detrimental immunologic effects of low early-life SES environments may be partly diminished through supportive family climates.
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Khanolkar A, Vågerö D, Koupil I. Social determinants of cardiac disease biomarkers: investigating a Swedish male cohort at ages 50 and 70. Eur J Prev Cardiol 2011; 19:523-33. [PMID: 21450563 DOI: 10.1177/1741826711405952] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social status is associated with cardiovascular disease (CVD) prevalence and incidence. AIMS to investigate relationships between socioeconomic position (SEP) and common CVD biomarkers including adiponectin not previously investigated in a Swedish-population sample, and to assess if these associations changed with age. DESIGN Population-based longitudinal cohort study of men born 1920-24 with clinical measurements, blood samples, questionnaire data, and register-based information on SEP and cause of death. METHODS A total of 2322 men attended an investigation at age 50 of which 1221 attended a reinvestigation at age 70. Association between SEP and CVD biomarkers [cholesterol, low-density lipoprotein/high-density lipoprotein (LDL/HDL), apolipoprotein (Apo) ApoB/ApoA1, and adiponectin] were analysed by linear regression (adjusted for age, body mass index, and physical activity). SEP was measured as occupational class and educational level. CVD mortality over 36 years of follow-up was analysed by Cox regression. RESULTS At age 50, we found a significant inverse association of education with cholesterol level, LDL/HDL ratio and ApoB/ApoA1 ratio. Cholesterol was also associated with occupational class, statistically significant after adjustment for all covariates. At age 70, no significant associations were found between either measurement of SEP and any of the biomarkers studied. Highest educated men had decreased risk for CVD mortality during follow-up. CONCLUSIONS Associations of SEP with cholesterol levels and LDL/HDL ratio that exist at age 50 are no longer apparent in the same group of men at age 70. We found no significant association between SEP and adiponectin levels at age 70.
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Affiliation(s)
- Amal Khanolkar
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.
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Pappa E, Kontodimopoulos N, Papadopoulos AA, Pallikarona G, Niakas D, Tountas Y. Factors affecting use of preventive tests for cardiovascular risk among Greeks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2712-24. [PMID: 20054464 PMCID: PMC2790102 DOI: 10.3390/ijerph6102712] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 10/19/2009] [Indexed: 12/02/2022]
Abstract
Data from a Greek national representative sample was used to investigate socio-demographic, self-perceived health, and health risk factors that determine the use of cardiovascular preventive tests (blood pressure, cholesterol and blood glucose). Chi-square and logistic regression analyses were used (p < 0.05). Older age, marriage, regular family doctor and chronic diseases increased the likelihood of receiving preventive tests, whereas low education and alcohol consumption reduced the likelihood of having these tests. The effect of obesity varied. Interventions which improve the knowledge of the poorly educated and empower the preventive role of the physicians may redress the inequalities and improve the effectiveness of preventive services utilization.
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Affiliation(s)
- Evelina Pappa
- Hellenic Open University, Faculty of Social Sciences, Bouboulinas 57, Patras, 26222, Greece; E-Mails:
(N.K.);
(A.A.P.);
(D.N.)
- Author to whom correspondence should be addressed; E-mail:
; Tel.: +30-2610-367441; Fax: +30-2610-367442
| | - Nick Kontodimopoulos
- Hellenic Open University, Faculty of Social Sciences, Bouboulinas 57, Patras, 26222, Greece; E-Mails:
(N.K.);
(A.A.P.);
(D.N.)
| | - Angelos A. Papadopoulos
- Hellenic Open University, Faculty of Social Sciences, Bouboulinas 57, Patras, 26222, Greece; E-Mails:
(N.K.);
(A.A.P.);
(D.N.)
- “ATTIKON” University Hospital, 1 Rimini Street, Athens, 12462, Greece
| | - Georgia Pallikarona
- Centre for Health Services Research, Department of Hygiene and Epidemiology, Medical School, Athens University, 25 Alexandroupoleos Street, Athens, 11527, Greece; E-Mail:
(Y.T.)
| | - Dimitris Niakas
- Hellenic Open University, Faculty of Social Sciences, Bouboulinas 57, Patras, 26222, Greece; E-Mails:
(N.K.);
(A.A.P.);
(D.N.)
| | - Yannis Tountas
- Hellenic Open University, Faculty of Social Sciences, Bouboulinas 57, Patras, 26222, Greece; E-Mails:
(N.K.);
(A.A.P.);
(D.N.)
- Centre for Health Services Research, Department of Hygiene and Epidemiology, Medical School, Athens University, 25 Alexandroupoleos Street, Athens, 11527, Greece; E-Mail:
(Y.T.)
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Abstract
Deprivation is associated with poor pregnancy outcome but the role of nutrition as a mediating factor is not well understood. We carried out a prospective cohort study of 1461 singleton pregnancies in Aberdeen, UK during 2000-6. We measured nutrient intake and supplement use, B vitamin and homocysteine status, birth weight, gestational age, neonatal treatment and socio-economic deprivation status. Women in the most deprived deciles were approximately 6 years younger and half as likely to take folic acid supplements periconceptually as the least deprived mothers. Deprivation was associated with low blood folate, high homocysteine and diets low in protein, fibre and many of the vitamins and minerals. The diets of the more deprived women were also characterised by low intakes of fruit, vegetables and oily fish and higher intakes of processed meat, fried potatoes, crisps and snacks. Deprivation was related to preterm birth (OR 1.14 (95 % CI 1.03, 1.25); P = 0.009) and whether the baby required neonatal treatment (OR 1.07 (95 % CI 1.01, 1.14); P = 0.028). Low birth weight was more common in women consuming diets low in vitamin C (OR 0.79 (95 % CI 0.64, 0.97); P = 0.028), riboflavin (OR 0.77 (95 % CI 0.63, 0.93); P = 0.008), pantothenic acid (OR 0.79 (95 % CI 0.65, 0.97); P = 0.023) and sugars (OR 0.78 (95 % CI 0.64, 0.96); P = 0.017) even after adjustment for deprivation index, smoking, marital status and parity. Deprivation in pregnancy is associated with diets poor in specific nutrients and poor diet appears to contribute to inequalities in pregnancy outcome. Improving the nutrient intake of disadvantaged women of childbearing age may potentially improve pregnancy outcome.
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Chimonas T, Fanouraki I, Liberopoulos EN, Chimonas E, Elisaf M. Diverging trends in cardiovascular morbidity and mortality in a low risk population. Eur J Epidemiol 2009; 24:415-23. [PMID: 19533384 DOI: 10.1007/s10654-009-9362-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 06/03/2009] [Indexed: 10/20/2022]
Abstract
Cardiovascular (CVD) disease morbidity and mortality are changing over the years, following changes in socioeconomic conditions and underlying risk factors. However, the trends of these changes differ among various populations. There is little data regarding these trends in low CVD risk populations. Tables of deaths by cause and age for the period 1956-2007 and tables of hospitalizations for the period 1979-2003 published by the National Statistical Service of Greece were used. Trends over time were determined using log-linear regression models. Age-adjusted all-cause mortality has declined steadily since 1964 in both sexes. CVD mortality initially increased until the late 1980s and subsequently decreased. An increase in mortality from stroke was seen until 1978, especially in men, followed by a decline. Mortality from coronary heart disease (CHD) increased initially, continued to increase for one decade more than stroke and started to decrease in 1989. However, only in women has CHD mortality returned below 1956 levels. As a result, deaths from CHD have surpassed those from stroke. Although the in-hospital fatality of acute myocardial infarction (AMI) has decreased by half between 1979 and 2003, deaths from AMI have decreased only slightly, as hospitalization and morbidity rates have increased during the same period. Although the various types of CVD share common risk factors, the trends of their respective mortality rates have differed significantly over the past five decades in the Greek population. This could partly be explained by the fact that risk factors do not equally contribute to CHD and stroke, and they might have not all been equally well controlled.
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Abstract
BACKGROUND Vital exhaustion has been shown to be a significant risk factor contributing to coronary heart disease, as well as a predictor of a worse prognosis among coronary patients. Socioeconomic differences in vital exhaustion may be part of the causal mechanism in the health and mortality inequalities connected with socioeconomic disadvantage. Our aim was to explore socioeconomic inequalities in vital exhaustion among coronary patients. METHODS We included 362 patients (32% women, mean age 56+/-7.3 years) who were referred for coronary angiography. The Maastricht interview for vital exhaustion was conducted with each patient. Level of income and education were used as indicators of socioeconomic status. Functional status was assessed with the NYHA (dyspnoe symptoms) and CCS (chest pain) scales. RESULTS Logistic regression showed significant socioeconomic inequalities in vital exhaustion among patients. Participants with low and middle income and education had a higher probability of being exhausted in comparison with patients with high income and education [odds ratio (95% confidence interval): 13.31 (4.67-37.94) and 2.10 (1.19-3.64), respectively]. Associations remained statistically significant after controlling for the effect of functional status and seriousness of disease. Socioeconomic differences were more salient among men than among women. CONCLUSION Low education and income seem to be strongly associated with higher vital exhaustion among patients; a significant factor contributing to worse prognosis and lower quality of life among patients with coronary heart disease.
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Gimeno D, Brunner EJ, Lowe GDO, Rumley A, Marmot MG, Ferrie JE. Adult socioeconomic position, C-reactive protein and interleukin-6 in the Whitehall II prospective study. Eur J Epidemiol 2007; 22:675-83. [PMID: 17668278 DOI: 10.1007/s10654-007-9171-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Accepted: 07/12/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND Prior studies on the association of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), with socioeconomic position (SEP) have been cross-sectional. Thus, the question of whether socioeconomic differences in CRP and IL-6 change over time remains unanswered. We examined the relationship between SEP and changes over 12 years in CRP and IL-6. METHODS Data were for 4,750 middle-aged (mean 49.0 years, SD 5.9) civil servants from phases 3 and 7 of the Whitehall II study. Adult SEP was based on last known Civil Service employment grade. Covariates included sociodemographics, behavioural and biological risk factors, presence of diseases/illnesses, prescribed medications, work-related factors, labour market status and early life factors. RESULTS Steep socioeconomic gradients observed at Phase 3 (p < 0.001) persisted in both CRP and IL-6 12 years later after adjustment for other risk factors. Adjustment for behavioural (diet and smoking), biological (mainly body mass index and total : HDL cholesterol ratio) and early life factors resulted in considerable attenuation but the inverse socioeconomic gradients remained statistically significant. Although CRP and IL-6 concentrations increased substantially over the 12-year period at every level of SEP, CRP and IL-6 did not change differentially according to SEP. CONCLUSION Despite overall increases in CRP and IL6, relative differences by SEP remained unchanged so that socioeconomic gradients in both sexes persisted over the period observed.
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Affiliation(s)
- David Gimeno
- International Institute for Society and Health, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
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Pollitt RA, Kaufman JS, Rose KM, Diez-Roux AV, Zeng D, Heiss G. Early-life and adult socioeconomic status and inflammatory risk markers in adulthood. Eur J Epidemiol 2007; 22:55-66. [PMID: 17225957 DOI: 10.1007/s10654-006-9082-1] [Citation(s) in RCA: 157] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Accepted: 11/07/2006] [Indexed: 01/04/2023]
Abstract
BACKGROUND Associations between childhood and adult socioeconomic status (SES) and adult levels of inflammatory markers (C-reactive protein [CRP], fibrinogen, white blood cell count [WBC], and von Willebrand factor [vWF]) were examined in the Atherosclerosis Risk in Communities (ARIC) Study cohort. METHODS A total of 12,681 white and African-American participants provided information on SES (via education and social class) and place of residence in childhood and adulthood. Residences were linked to census data for neighborhood SES information. Multiple imputation was used to impute missing data. Hierarchical and linear regression were used to estimate the effects of SES and possible mediation by adult cardiovascular disease (CVD) risk factors. FINDINGS Low childhood social class and education were associated with elevated levels of CRP, fibrinogen, WBC, and vWF (increments of 17%, 2%, 4% and 3% for lowest versus highest education in childhood, respectively) among whites. Findings were less consistent among African-Americans. Adult SES was more strongly associated with inflammation than childhood SES. Individual-level SES measures were more consistently associated with inflammation than neighborhood-level measures. Fibrinogen and WBC showed the most consistent associations with SES; the largest changes in inflammation by SES were observed for CRP. Covariate adjustment strongly attenuated these associations. Mediation of the SES-inflammation associations by BMI, smoking and HDL cholesterol (HDL-C) are suggested by these data. CONCLUSION Low individual- and neighborhood-level SES in childhood and adulthood are associated with modest increments in adult inflammatory burden. These associations may operate through the influence of low SES on traditional CVD risk factors, especially BMI, smoking and HDL-C.
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Affiliation(s)
- Ricardo A Pollitt
- Department of Epidemiology, School of Public Health, The University of North Carolina at Chapel Hill, 137 E. Franklin Street, Bank of America Center, Chapel Hill, NC 27514, USA.
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Morasco BJ, Pietrzak RH, Blanco C, Grant BF, Hasin D, Petry NM. Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med 2006; 68:976-84. [PMID: 17132843 DOI: 10.1097/01.psy.0000238466.76172.cd] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Pathologic gambling is believed to be associated with adverse health consequences, but no prior studies have rigorously evaluated these relationships. We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling. METHOD A total of 43,093 adults aged 18 years and older were evaluated in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions. Self-reported medical diagnoses and past-year medical services used were assessed. RESULTS Pathologic gamblers were more likely than low-risk individuals to have been diagnosed with tachycardia (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.05-2.97), angina (OR = 2.35; 95% CI = 1.33-4.15), cirrhosis (OR = 3.90; 95% CI = 1.11-13.72), and other liver disease (OR = 2.98; 95% CI = 1.07-8.26). Gambling severity was also associated with higher rates of medical utilization with pathologic gamblers more likely than low-risk individuals to have been treated in the emergency room in the year before the survey (OR = 1.98; 95% CI = 1.27-3.09). Significant effects of gambling severity remained even after controlling for demographic characteristics (age, gender, ethnicity, marital status, education, income, and region of the country) and behavioral risk factors such as body mass index, alcohol abuse and dependence, nicotine dependence, and mood and anxiety disorders. CONCLUSIONS A lifetime diagnosis of pathologic gambling is associated with several medical disorders and increased medical utilization, perhaps leading to a burden on healthcare costs in the United States.
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Affiliation(s)
- Benjamin J Morasco
- Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
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