Socioeconomic position, inflammation, and cardiovascular health in childhood and adolescence: an international multi-cohort study — The Association Specialists
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Socioeconomic position, inflammation, and cardiovascular health in childhood and adolescence: an international multi-cohort study (23791)

Kavindi Gamage 1 , Susanna Patsi 2 , Tong Chen 3 , Kate Mooney 4 , Sylvain Sebert 2 , Naomi Priest 3 , David Burgner 3 , Toby Mansell 3
  1. University of Melbourne, Melbourne
  2. University of Oulu, Oulu
  3. Murdoch Children's Research Institute, Melbourne
  4. University of York, York

Background: Inflammation may be an important intermediate mechanism underlying socioeconomic inequalities in cardiovascular disease (CVD). As CVD risk accrues from childhood onwards, we aimed to investigate how cardiovascular health (CVH) in children and adolescents is patterned by socioeconomic position (SEP) and associated with inflammation.

Methods: We analysed 5 longitudinal cohorts: the Barwon Infant Study (BIS, Australia, mean age 4.1 years, n=708); Born in Bradford (United Kingdom, mean age 9.3 years, n=4576); the Longitudinal Study of Australian Children’s Child Health CheckPoint (LSAC-CP, Australia, mean 12.0 years, n=1874); the Northern Finland Birth Cohort 1986 (NFBC1986) (Finland, mean 16.0 years, n=9467); and the Avon Longitudinal Study of Parents and Children (ALSPAC, United Kingdom, mean 17.8 years, n=4875). Indicators of SEP were neighbourhood disadvantage, household SEP, and maternal education (in pregnancy/at birth). Inflammatory biomarkers were log-transformed high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA). Measures of CVH were carotid intima-media thickness, pulse wave velocity, blood pressure, and lipids.

Results: From 12 years, children with lower SEP had worse CVH, adjusted for age, sex, and ethnicity. For example, LSAC-CP 12-year-olds in the most disadvantaged neighbourhoods had higher pulse wave velocity (β = 0.1 m/s; 95% CI, 0.03-0.2; P=0.003) than those in the most advantaged. Higher inflammation was linked to worse CVH, particularly lipids, across all cohorts. Intervening on inflammation would reduce some inequalities in CVH (e.g., for GlycA, estimated 83% of neighbourhood inequalities in triglycerides in LSAC-CP).

Conclusions: Socioeconomic inequalities in CVH are apparent from childhood and may be partially explained by heightened inflammation. Efforts to improve socioeconomic conditions and reduce inflammation in early life may improve lifecourse risk trajectories.