Understanding the relation between socioeconomic position and inflammation in post-menopausal women: education, income and occupational prestige.

Background: The role of occupational prestige, a direct measure of the perceived status of job and job holder, in inflammation is unknown. To contribute to understanding the pathways by which socioeconomic position (SEP) is associated with inflammation, we aimed to estimate the direct effects of education, income and occupational prestige on C-reactive protein (CRP) and to describe the relationship between these markers and CRP. Methods: The study was based on 2026 post-menopausal women enrolled in the Women's Health Initiative-Observational Study. Occupational prestige was determined by linking a text description of longest held occupation with a social status item from the Occupational Information Network. Path analysis was employed to estimate direct and mediated effects. Results: The study suggests that higher levels of education, income, and occupational prestige are associated with 8% (95% CI as percentage change -12, -4), 5% [95% CI (-8, -2) and 4% (95% CI - 7, -1)] lower levels of CRP, respectively. The inverse association between education and CRP was explained by the effect of education on income and occupational prestige. The effect of occupational prestige on CRP was independent of mediators in the model. Conclusions: The findings indicate that education may work to influence CRP primarily through increasing income and occupational prestige and provides evidence that occupational prestige captures a unique aspect of SEP.

Maternal infections during pregnancy and offspring midlife inflammation.

BACKGROUND: Microbial exposures early in life have been found to be associated with lower levels of inflammation in adulthood; however, the role of prenatal exposure to infection on offspring inflammatory profiles is unexplored. The aim was to study if maternal infections during pregnancy are associated with inflammation among offspring in later life and to determine if there are sensitive periods of exposure. METHODS: The study was comprised of 1719 participants in the Copenhagen Aging and Midlife Biobank (CAMB) who were also members of the Copenhagen Perinatal Cohort (CPC). When the CPC was established, information on maternal infections during pregnancy was prospectively collected by a trained medical doctor. The inflammatory measures collected in late midlife included, C-reactive protein (CRP), Interleukin-6 (IL-6), TNF-alpha (TNF-α) and Interleukin-10 (IL-10). Multivariable ordinary least squared regression models were implemented to explore associations between maternal infection and inflammatory measures in offspring, controlling for maternal smoking, pre-pregnancy body mass index, age, marital status and parity. RESULTS: Maternal infection was associated with a 7% lower CRP level (95% CI, - 17,5%) among offspring compared with offspring born to women without an infection and similarly an 8% lower level of IL-6 (95% CI -15,1%), and a 9% lower level of IL-10 (95% CI, - 23,20%). However, differences did not reach significance. The effects of infection during the first trimester did not differ from infections later in the pregnancy. CONCLUSIONS: Our results suggested that prenatal exposure to infection may be associated with lower levels of inflammatory markers among adult offspring. Additional prospective studies are needed to further explore this finding.

Prenatal and early postnatal stress and later life inflammation.

BACKGROUND: Evidence suggests that maternal psychological and social stress during the prenatal period and in childhood represent an important condition that may adversely impact the anatomy and physiology of the developing child with implications for a number of health-related conditions and disorders. In a large prospective study, we aim to address if social stressors in the prenatal and early postnatal periods, as individual exposures as well as their accumulation, are associated with a range of inflammatory markers in late middle-aged offspring. METHODS: The study sample includes Danish men and women born between 1959 and 1961 (n = 1206) who were members of the Copenhagen Perinatal Cohort and participated in the Copenhagen Aging and Midlife Biobank in 2009-2011 (age 49-52). Information on social stressors was collected through an interview with the mothers at the first antenatal visit and postnatal stressor data was collected at year one follow-up. A series of ordinary least square regression models were performed with the stress measures as the exposures and C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-10 (IL-10), and Tumor necrosis factor α (TNF-α) separately as the outcomes. RESULTS: The individual prenatal maternal stressors (being unmarried and having an unwanted pregnancy) and the prenatal index were associated with higher levels of CRP and IL-6 among offspring but not with IL-10 or TNF-α. Low social status, but not living away from parents or having an unmarried mother in the first year of life, was associated with higher levels of CRP and IL-6. The accumulation of social stressors in the early postnatal period was associated with higher levels of CRP and IL-6 but not IL-10 and TNF-α. The accumulation of stressors in the prenatal and postnatal periods combined was associated with higher levels of CRP and IL-6, but not with IL-10 or TNF-α. CONCLUSIONS: The findings suggest that exposure to the accumulation of prenatal and early life stressors, is associated with higher levels of CRP and IL-6 in later life. This may indicate that the effects of early stressors on later inflammation operate through pathways with clear links to cardiovascular disease.

Psychosocial risk factors for the metabolic syndrome: A prospective cohort study.

BACKGROUND/OBJECTIVES: Metabolic deregulations and development of metabolic syndrome may be an important pathway underlying the relationship between stress and cardiovascular disease. We aim to estimate the effect of a comprehensive range of psychosocial factors on the risk of developing metabolic syndrome in men and women. METHODS: The study population consisted of 3621 men and women from the Copenhagen City Heart Study who were free of metabolic syndrome at baseline and reexamined after 10years. The data was analyzed by multivariable logistic regression models adjusted for age, education, income, menopausal status and life style factors. RESULTS: We found major life events in adult life (OR 1.48, 95% CI 0.93 to 2.36) and major life events at work (OR 2.75, 95% CI 1.38 to 5.50), lacking a confidant (OR 1.94, 95% CI 1.07 to 3.53) and dissatisfaction with social network (OR 1.53, 95% CI 1.11 to 2.11) to be risk factors for developing the metabolic syndrome in women, while vital exhaustion (OR 2.09, 95% CI 0.95 to 4.59) and intake of sleep medications (OR 2.54, 95% CI 0.92 to 5.96) may play a more important role in men. CONCLUSIONS: Experiencing major life events in work and adult life and/or dysfunctional social networks is a risk factor for metabolic syndrome in women, and stress reactions such as vital exhaustion and intake of sleep medications may play a more important role in the development of metabolic syndrome men.

Late midlife C-reactive protein and interleukin-6 in middle aged danish men in relation to body size history within and across generations.

OBJECTIVE: The aim was to estimate the effects of ponderal index at birth and body mass index (BMI) in early adulthood on C-reactive protein (CRP) and interleukin-6 (IL-6) and to quantify the effects through subsequent measures of body size. In a subanalysis, the contributions of maternal BMI to the inflammatory status of offspring were investigated. METHODS: The study was based on 2,986 Danish males from the Copenhagen Aging and Midlife Biobank. Path analysis was employed to estimate direct and indirect effects. RESULTS: A 10% higher maternal BMI was associated with 7% higher CRP and 3% higher IL-6 among offspring. A 10% higher ponderal index at birth was associated with 4% lower CRP in late midlife; this effect was only partially mediated by later growth. A 10% higher BMI in early adulthood was associated with 8% higher CRP and 4% higher IL-6 in late midlife. The findings suggest that weight gain in adulthood is associated with low-grade inflammation in late midlife. CONCLUSIONS: Ponderal index at birth is associated with CRP in later life independently of adult BMI. The findings additionally suggest that preventing weight gain in early adulthood would be beneficial for inflammatory status in later life.