The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA)
Cardiovascular disease and diabetes are leading causes of morbidity and mortality worldwide. Social inequalities in the distribution of these diseases across the population exist. The aim of the current study was to examine the additive effect of socioeconomic position and a known biological risk ma...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | SSM: Population Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827323001854 |
| _version_ | 1797429967102935040 |
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| author | Lydia Poole Antonio I. Lazzarino Kimberley J. Smith Ruth A. Hackett |
| author_facet | Lydia Poole Antonio I. Lazzarino Kimberley J. Smith Ruth A. Hackett |
| author_sort | Lydia Poole |
| collection | DOAJ |
| description | Cardiovascular disease and diabetes are leading causes of morbidity and mortality worldwide. Social inequalities in the distribution of these diseases across the population exist. The aim of the current study was to examine the additive effect of socioeconomic position and a known biological risk marker (C-reactive protein [CRP]) for future incident cardiometabolic disease. We used data from the English Longitudinal Study of Ageing (N = 5410). Tertiles of net financial wealth and CRP (>3 mg/L) were measured at wave 2 (2004/05) and disease incidence (coronary heart disease [CHD], stroke, diabetes/high blood glucose) was reported across the subsequent 14 years of follow-up (2006–2019). Individual diseases were modelled as well as cardiometabolic multimorbidity which was defined as 2 or more incident cardiometabolic disease diagnoses over follow-up. Participants were free from the disease of interest at baseline. Cox proportional hazard and logistic regression analyses were used controlling for sociodemographic, lifestyle and health-related covariates. After adjusting for all covariates, the combination of low wealth and elevated CRP was an independent predictor of incident diabetes/high blood glucose (Hazard Ratio (HR) = 2.14; 95% Confidence Interval (C.I.) = 1.49–3.07), CHD (HR = 2.48, 95% C.I. = 1.63–3.76), stroke (HR = 1.55; 95% C.I. = 1.18–2.04), relative to high wealth/low CRP. Low wealth and elevated CRP was also an independent predictor of incident cardiometabolic multimorbidity (Odds Ratio = 2.22, 95% C.I. = 1.16–4.28) in age and sex adjusted models. The presence of both low wealth and elevated CRP was implicated in the onset of CHD, stroke, diabetes/high blood glucose, and cardiometabolic multimorbidity up to 14 years later, reflecting the role of psychobiological processes in predicting disease burden. Our results reinforce calls for efforts to tackle structural inequalities to improve healthy ageing trajectories. |
| first_indexed | 2024-03-09T09:20:55Z |
| format | Article |
| id | doaj.art-319b3637484c422dbf55119765c15d8c |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-03-09T09:20:55Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-319b3637484c422dbf55119765c15d8c2023-12-02T07:00:40ZengElsevierSSM: Population Health2352-82732023-12-0124101520The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA)Lydia Poole0Antonio I. Lazzarino1Kimberley J. Smith2Ruth A. Hackett3Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, United Kingdom; Corresponding author. Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, GU2 7XH, United Kingdom.Department of Epidemiology and Biostatistics, Imperial College London, London, United KingdomDepartment of Psychological Interventions, School of Psychology, University of Surrey, Guildford, United KingdomHealth Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United KingdomCardiovascular disease and diabetes are leading causes of morbidity and mortality worldwide. Social inequalities in the distribution of these diseases across the population exist. The aim of the current study was to examine the additive effect of socioeconomic position and a known biological risk marker (C-reactive protein [CRP]) for future incident cardiometabolic disease. We used data from the English Longitudinal Study of Ageing (N = 5410). Tertiles of net financial wealth and CRP (>3 mg/L) were measured at wave 2 (2004/05) and disease incidence (coronary heart disease [CHD], stroke, diabetes/high blood glucose) was reported across the subsequent 14 years of follow-up (2006–2019). Individual diseases were modelled as well as cardiometabolic multimorbidity which was defined as 2 or more incident cardiometabolic disease diagnoses over follow-up. Participants were free from the disease of interest at baseline. Cox proportional hazard and logistic regression analyses were used controlling for sociodemographic, lifestyle and health-related covariates. After adjusting for all covariates, the combination of low wealth and elevated CRP was an independent predictor of incident diabetes/high blood glucose (Hazard Ratio (HR) = 2.14; 95% Confidence Interval (C.I.) = 1.49–3.07), CHD (HR = 2.48, 95% C.I. = 1.63–3.76), stroke (HR = 1.55; 95% C.I. = 1.18–2.04), relative to high wealth/low CRP. Low wealth and elevated CRP was also an independent predictor of incident cardiometabolic multimorbidity (Odds Ratio = 2.22, 95% C.I. = 1.16–4.28) in age and sex adjusted models. The presence of both low wealth and elevated CRP was implicated in the onset of CHD, stroke, diabetes/high blood glucose, and cardiometabolic multimorbidity up to 14 years later, reflecting the role of psychobiological processes in predicting disease burden. Our results reinforce calls for efforts to tackle structural inequalities to improve healthy ageing trajectories.http://www.sciencedirect.com/science/article/pii/S2352827323001854Socioeconomic positionWealthC-reactive proteinCoronary heart diseaseStrokeDiabetes |
| spellingShingle | Lydia Poole Antonio I. Lazzarino Kimberley J. Smith Ruth A. Hackett The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA) SSM: Population Health Socioeconomic position Wealth C-reactive protein Coronary heart disease Stroke Diabetes |
| title | The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA) |
| title_full | The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA) |
| title_fullStr | The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA) |
| title_full_unstemmed | The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA) |
| title_short | The combined effect of socioeconomic position and C-reactive protein for predicting incident cardiometabolic disease: Findings from a 14-year follow-up study of the English Longitudinal Study of Ageing (ELSA) |
| title_sort | combined effect of socioeconomic position and c reactive protein for predicting incident cardiometabolic disease findings from a 14 year follow up study of the english longitudinal study of ageing elsa |
| topic | Socioeconomic position Wealth C-reactive protein Coronary heart disease Stroke Diabetes |
| url | http://www.sciencedirect.com/science/article/pii/S2352827323001854 |
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