American Journal of Epidemiology Advance Access originally published online on March 25, 2008
American Journal of Epidemiology 2008 167(11):1332-1341; doi:10.1093/aje/kwn055
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ORIGINAL CONTRIBUTIONS |
Effects of Socioeconomic Position on Inflammatory and Hemostatic Markers: A Life-Course Analysis in the 1958 British Birth Cohort
1 Department of Epidemiology and Public Health, University College London, London, United Kingdom
2 Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow, United Kingdom
3 Centre for Pediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, United Kingdom
4 Division of Community Health Sciences, St. George's, University of London, London, United Kingdom
Correspondence to Dr. Faiza Tabassum, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, United Kingdom (e-mail: f.tabassum{at}ucl.ac.uk).
Received for publication April 2, 2007. Accepted for publication February 15, 2008.
The cumulative effects of socioeconomic position (SEP) on cardiovascular disease have been described, but the pathways are unclear. In this study, the authors examined the effects of life-course SEP on inflammatory and hemostatic markers: fibrinogen, C-reactive protein, von Willebrand factor antigen, and tissue plasminogen activator antigen. Data from the 1958 British birth cohort, including data on persons who underwent a biomedical follow-up in 2002–2004, were used. Social class was determined at three stages of respondents' lives: childhood (birth), early adulthood (age 23 years), and midlife (age 42 years). A cumulative indicator score of SEP was calculated that ranged from 0 (always in the highest social class) to 9 (always in the lowest social class). In men and women, associations were observed between cumulative indicator score and fibrinogen (p < 0.001), C-reactive protein (p < 0.001), von Willebrand factor antigen (p 
0.05), and tissue plasminogen activator antigen (p < 0.001 only in women). The trends in fibrinogen and C-reactive protein remained after adjustment for body mass index, smoking, and physical activity. However, the trends became nonsignificant for von Willebrand factor antigen and tissue plasminogen activator antigen in women. Risk exposure related to SEP accumulates across the life course and contributes to raised levels of fibrinogen and C-reactive protein, while childhood SEP influences hemostatic markers more than does adult SEP.
cohort studies; C-reactive protein; fibrinogen; hemostasis; inflammation; social class; tissue plasminogen activator; von Willebrand factor
Abbreviations: CIS, cumulative indicator score; SEP, socioeconomic position