Childhood Socioeconomic Status in Predicting Metabolic Syndrome and Glucose Abnormalities in Adulthood: The Cardiovascular Risk in Young Finns Study

Author:

Puolakka Elina1,Pahkala Katja12,Laitinen Tomi T.12,Magnussen Costan G.13,Hutri-Kähönen Nina4,Tossavainen Päivi5,Jokinen Eero6,Sabin Matthew A.7,Laitinen Tomi8,Elovainio Marko9,Pulkki-Råback Laura910,Viikari Jorma S.A.11,Raitakari Olli T.112,Juonala Markus111

Affiliation:

1. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

2. Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland

3. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia

4. Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland

5. Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland

6. Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland

7. Murdoch Childrens Research Institute, Royal Children’s Hospital, and Department of Paediatrics, University of Melbourne, Melbourne, Australia

8. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland

9. Unit of Personality, Work and Health, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland

10. Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland

11. Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland

12. Department of Clinical Physiology and Nuclear Medicine, University of Turku, and Turku University Hospital, Turku, Finland

Abstract

OBJECTIVE We prospectively examined whether family socioeconomic status (SES) in childhood is associated with metabolic syndrome (MetS), impaired fasting glucose (IFG), or type 2 diabetes in adulthood. RESEARCH DESIGN AND METHODS The sample comprised 2,250 participants from the longitudinal Cardiovascular Risk in Young Finns Study cohort. Participants were 3–18 years old at baseline (mean age 10.6 years), and they were followed for 31 years. SES was characterized as reported annual income of the family and classified on an 8-point scale. RESULTS For each 1-unit increase in family SES in childhood, the risk for adult MetS decreased (risk ratio [95% confidence interval] 0.94 [0.90–0.98]; P = 0.003) when adjusted for age, sex, childhood cardiometabolic risk factors (lipids, systolic blood pressure, insulin, and BMI), childhood physical activity, and fruit and vegetable consumption. The association remained after adjustment for participants’ own SES in adulthood (0.95 [0.91–0.99]; P = 0.005). A similar association was seen between childhood SES and the risk of having either adult IFG or type 2 diabetes (0.96 [0.92–0.99]; P = 0.01, age and sex adjusted). This association became nonsignificant after adjustment for childhood risk factors (P = 0.08). Of the individual components of MetS, lower SES in childhood predicted large waist circumference (0.96 [0.93–0.99]; P = 0.003) and a high triglycerides concentration (0.96 [0.92–1.00]; P = 0.04) after adjustment for the aforementioned risk factors. CONCLUSIONS Lower SES in childhood may be associated with an increased risk for MetS, IFG, and type 2 diabetes in adulthood. Special attention could be paid to children of low SES families to decrease the prevalence of MetS in adulthood.

Funder

National Heart Foundation of Australia Future Leader Fellowship

Suomen Akatemia

Social Insurance Institution of Finland

Kuopio, Tampere, and Turku University Hospital Medical Funds

Juho Vainio Foundation

Paavo Nurmi Foundation

Finnish Foundation of Cardiovascular Research

Finnish Cultural Foundation

Sigrid Juselius Foundation

Tampere Tuberculosis Foundation

Emil Aaltonen Foundation

Yrjö Jahnsson Foundation

National Health and Medical Research Council Project

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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