Understanding socioeconomic differences in incident metabolic syndrome among adults: What is the mediating role of health behaviours?

PREVENTIVE MEDICINE

卷:148

Article

Hoveling, Liza A.¹  Liefbroer, Aart C.^1,2,3  Bultmann, Ute⁴  Smidt, Nynke¹ 

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Epidemiol, POB 30-001, NL-9700 RB Groningen, Netherlands

[2] Netherlands Interdisciplinary Demog Inst, POB 11650, NL-2502 AR The Hague, Netherlands

[3] Vrije Univ Amsterdam, Dept Sociol, Boelelaan 1081, NL-1081 HV Amsterdam, Netherlands

[4] Univ Groningen, Univ Med Ctr Groningen, Dept Hlth Sci Community & Occupat Med, POB 30-001, NL-9700 RB Groningen, Netherlands

关键词: Metabolic syndrome;    Socioeconomic factors;    Physical activity;    Smoking;    Alcohol drinking;    Diet;    Longitudinal studies;    Mediation;   

DOI  :  10.1016/j.ypmed.2021.106537

来源: Elsevier

【 摘 要 】

Background: The incidence of metabolic syndrome (MetS) strongly varies by socioeconomic position (SEP), but little is known about the mediating role of health behaviours in this association. This study examines the associations between the SEP measures, education, income and occupational prestige, and incident MetS and whether the associations are mediated by health behaviours, including physical activity, smoking, alcohol intake and diet quality. Methods: A subsample (n = 85,910) of the adult Lifelines Cohort Study without MetS at baseline was used. MetS was measured at the second assessment (median follow-up time 3.8 years) defined according to the NCEP-ATPIII criteria. Direct associations between SEP, health behaviours and incident MetS were estimated using multivariable logistic regression analyses. The mediating percentages of health behaviours explaining the associations between SEP and incident MetS were estimated using the Karlson-Holm-Breen method. Analyses were independent of age, sex, the other SEP measures and follow-up time. Results: Education and occupational prestige were inversely associated with MetS. Income was not associated with MetS. Health behaviours explained only partly (13.8%) the association between education and MetS, with smoking as the strongest mediating factor (8.8%). Health behaviours played also a minor role (2.7%) in explaining occupational MetS differences, with physical activity as the strongest suppressing factor (-9.4%). Conclusion: Individuals with more years of education or a higher occupational prestige had a lower risk to develop MetS. This was mainly because of non-smoking, less excessive alcohol intake and a higher diet quality. However, individuals with a higher SEP were more often physically inactive.

【 授权许可】

Free