The Relationship Between Social And Economic Status Of Chinese Adult And The Pathogenesis Of Metabolic Syndrome

BackgroundMetabolic Syndrome (MS), as an important risk factor of cardiovascular disease, has became a global public health problem. During the past decades, the MS has become a serious threat to the health of Chinese and caused huge burden of disease in China due to its rapidly increased prevalence. Association between socioeconomic status (SES) and the risk of MS has been well examined mainly in developed countries. However, the results from several cross-sectional studies conducted in China were still controversial. The current study aimed to investigate the association between SES and the incidence of MS among Chinese adults.MethodsThe present cohort study was administered in a sample of 27 020 Chinese adults aged 35-74 years from China Multicenter Collaborative Study of Cardiovascular Epidemiology and the International Collaborative Study of Cardiovascular Disease in Asia. Baseline information on demographic characteristics, socioeconomic status, lifestyle risk factors, physical examinations and laboratory measurements were obtained in 1988 and 2000-2001, respectively. The follow-up examination was conducted in 2007-2008, data on components of MS and related risk factors were collected. A total of 12 608 (6 112 men and 6 496 women) participants were included in the final analysis. All participants were divided into three groups according to tertiles of the SES composite score, which was a latent variable comprising educational level, income and occupation. The adjusted RRs (95% CI) for MS were calculated using logistic regression analyses across educational level, income, occupation and SES composite index groups.ResultsAfter an average of 8.1 years follow-up,2 716(1 151 men and 1 565 women) incident MS cases were identified. The multi-variable adjusted relative risks (RRs) (95% confidence intervals (CIs)) of primary, junior high, senior high and college or above education level of 1.19 (0.99-1.44),1.13 (0.92-1.41),0.81 (0.63-1.04) and 0.54 (0.38-0.75), respectively in women (Ptrend<0.001), compared with illiteracy. Compared with those had per capita monthly household income<￥300, the multi-variable adjusted RRs (95%CIs) of participants with income of ￥300-499, ￥500-799, ￥800-1199 and ≥￥1200 were 1.20 (1.01-1.43),1.35 (1.11-1.62),1.37 (1.07-1.74) and 1.58 (1.15-2.15), respectively in men (Ptrend<0.001). The multi-variable adjusted RRs (95% CIs) of farmer, worker/service, retired, self-employed/technician and management were 0.69 (0.55-0.86), 0.83 (0.66-1.05),1.03 (0.82-1.30),0.69 (0.54-0.88) and 0.62 (0.48-0.81), respectively in women (Ptrend=0.001), in contrast to the reference group of unemployed participants. Compared with low SES composite index, the multi-variable adjusted RRs (95% CIs) of middle and high SES composite index groups were 1.46 (1.20-1.76) and 1.52 (1.21-1.91) in men (Ptrend=0.003), while those were 1.01 (0.87-1.17) and 0.75 (0.61-0.92) in their women counterparties (Ptrend=0.004), respectively.ConclusionsEducation level, income level, occupation, and SES composite index is closely related to the risk of MS, and they exist gender differences. The characteristics of SES in population should be taken into account in the prevention and control of MS and other cardiovascular disease risk factors.