Life Course Socioeconomic Conditions and Metabolic Syndrome in Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Purpose

This study examined the effect of childhood, adulthood, and cumulative socioeconomic status (cumSES) on the prevalence of metabolic syndrome (MetS) in middle-aged adults in the Atherosclerosis Risk in Communities Study (1987–1989).

Methods

Participants included 2,461 black and 8,536 white men and women 45 to 64 years of age without diabetes. Socioeconomic status (SES) measures from childhood, early adulthood, and mature adulthood were used to create a cumSES score. Childhood SES, early adult SES, mature adult SES and cumSES scores were grouped into two categories (high/low). Age- and center-adjusted prevalence ratios and 95% confidence intervals for MetS, using the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) criteria, by SES were estimated by log-linear regression for race-sex groups.

Results

Black and white women with low childhood SES, early adult SES, mature adult SES or cumSES were more likely to have the MetS than those with high SES. These associations remained after adjustment for physical activity, smoking status, and drinking status. In contrast, there was no association of SES with MetS in men.

Conclusions

Our findings suggest that socioeconomic disadvantage early in life and across the life course influences risk of the MetS in black and white women.

Key Words: Socioeconomic Status, Life Course, Childhood, Metabolic Syndrome

Selected Abbreviations and Acronyms: U.S., United States, MetS, metabolic syndrome, CHD, coronary heart disease, CVD, cardiovascular disease, SES, socioeconomic status, HPA, hypothalamic-pituitary-adrenocortical, ARIC, Atherosclerosis Risk in Communities (study), LC-SES, Life Course Socioeconomic Status, Social Context and Cardiovascular Disease, cumSES, cumulative socioeconomic status, HDL-C, high-density lipoprotein cholesterol, M, men, W, women, LDL-C, low-density lipoprotein cholesterol, PR, prevalence ratio, CI, confidence interval