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Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

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Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility? / Veronesi, Giovanni; Kee, Frank; Hicks, Blanaid; Forrest, Hannah; Tunstall-Pedoe, Hugh; Kuulasmaa, Kari; Sans, Susana; Salomaa, Veikko; Thorand, Barbara; Di Castelnuovo, Augusto; Soderberg, Stefan; Cesana, Giancarlo; Bobak, Martin; De Ponti, Roberto; Iacoviello, Licia; Palmieri, Luigi; Zeller, Tanja; Blankenberg, Stefan; Ferrario, Marco M.

in: J EPIDEMIOL COMMUN H, Jahrgang 74, Nr. 12, 12.2020, S. 1008-1015.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Veronesi, G, Kee, F, Hicks, B, Forrest, H, Tunstall-Pedoe, H, Kuulasmaa, K, Sans, S, Salomaa, V, Thorand, B, Di Castelnuovo, A, Soderberg, S, Cesana, G, Bobak, M, De Ponti, R, Iacoviello, L, Palmieri, L, Zeller, T, Blankenberg, S & Ferrario, MM 2020, 'Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?', J EPIDEMIOL COMMUN H, Jg. 74, Nr. 12, S. 1008-1015. https://doi.org/10.1136/jech-2020-213946

APA

Veronesi, G., Kee, F., Hicks, B., Forrest, H., Tunstall-Pedoe, H., Kuulasmaa, K., Sans, S., Salomaa, V., Thorand, B., Di Castelnuovo, A., Soderberg, S., Cesana, G., Bobak, M., De Ponti, R., Iacoviello, L., Palmieri, L., Zeller, T., Blankenberg, S., & Ferrario, M. M. (2020). Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility? J EPIDEMIOL COMMUN H, 74(12), 1008-1015. https://doi.org/10.1136/jech-2020-213946

Vancouver

Veronesi G, Kee F, Hicks B, Forrest H, Tunstall-Pedoe H, Kuulasmaa K et al. Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility? J EPIDEMIOL COMMUN H. 2020 Dez;74(12):1008-1015. https://doi.org/10.1136/jech-2020-213946

Bibtex

@article{9342ffe7c39c4584a5eadd4700ac243c,
title = "Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?",
abstract = "BACKGROUND: We investigate whether socially disadvantaged individuals are more susceptible to the detrimental effects of smoking and alcohol intake on allostatic load (AL), a marker of physiological 'wear and tear', resulting from adaptation to chronic stress.METHODS: In a cross-sectional analysis, 27 019 men and 26 738 women aged 35-74 years were identified from 21 European cohorts in the BiomarCaRE consortium. We defined three educational classes (EDs) according to years of schooling and an AL score as the sum of z-scores of eight selected biomarkers from the cardiovascular, metabolic and inflammatory systems. We used the Oaxaca-Blinder decomposition to disentangle the ED gradient in AL score into the differential exposure (DE, attributable to different distribution of smoking and alcohol intake across EDs) and the differential susceptibility (DS, attributable to a different effect of risk factors on AL across EDs) components.RESULTS: Less-educated men (mean AL difference: 0.68, 95% CI 0.57 to 0.79) and women (1.52, 95% CI 1.40 to 1.64) had higher AL scores. DE accounted for 7% and 6% of the gradient in men and women, respectively. In men, combining smoking and alcohol intake, DS accounted for 42% of the gradient (smoking DS coefficient=0.177, 26% of the gradient; alcohol DS coefficient=0.109; 16%, not statistically significant). DS contribution increased to 69% in metabolic markers. DS estimates were consistent across age groups, irrespective of comorbidities and robust to unmeasured confounding. No DS was observed in women.CONCLUSIONS: In men, a DS mechanism substantially contributes to the educational class gradient in allostatic load.",
keywords = "Alcohol Drinking/adverse effects, Allostasis, Cross-Sectional Studies, Educational Status, Europe, European Continental Ancestry Group, Female, Humans, Male, Smoking/adverse effects",
author = "Giovanni Veronesi and Frank Kee and Blanaid Hicks and Hannah Forrest and Hugh Tunstall-Pedoe and Kari Kuulasmaa and Susana Sans and Veikko Salomaa and Barbara Thorand and {Di Castelnuovo}, Augusto and Stefan Soderberg and Giancarlo Cesana and Martin Bobak and {De Ponti}, Roberto and Licia Iacoviello and Luigi Palmieri and Tanja Zeller and Stefan Blankenberg and Ferrario, {Marco M}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2020",
month = dec,
doi = "10.1136/jech-2020-213946",
language = "English",
volume = "74",
pages = "1008--1015",
journal = "J EPIDEMIOL COMMUN H",
issn = "0143-005X",
publisher = "BMJ PUBLISHING GROUP",
number = "12",

}

RIS

TY - JOUR

T1 - Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

AU - Veronesi, Giovanni

AU - Kee, Frank

AU - Hicks, Blanaid

AU - Forrest, Hannah

AU - Tunstall-Pedoe, Hugh

AU - Kuulasmaa, Kari

AU - Sans, Susana

AU - Salomaa, Veikko

AU - Thorand, Barbara

AU - Di Castelnuovo, Augusto

AU - Soderberg, Stefan

AU - Cesana, Giancarlo

AU - Bobak, Martin

AU - De Ponti, Roberto

AU - Iacoviello, Licia

AU - Palmieri, Luigi

AU - Zeller, Tanja

AU - Blankenberg, Stefan

AU - Ferrario, Marco M

N1 - © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND: We investigate whether socially disadvantaged individuals are more susceptible to the detrimental effects of smoking and alcohol intake on allostatic load (AL), a marker of physiological 'wear and tear', resulting from adaptation to chronic stress.METHODS: In a cross-sectional analysis, 27 019 men and 26 738 women aged 35-74 years were identified from 21 European cohorts in the BiomarCaRE consortium. We defined three educational classes (EDs) according to years of schooling and an AL score as the sum of z-scores of eight selected biomarkers from the cardiovascular, metabolic and inflammatory systems. We used the Oaxaca-Blinder decomposition to disentangle the ED gradient in AL score into the differential exposure (DE, attributable to different distribution of smoking and alcohol intake across EDs) and the differential susceptibility (DS, attributable to a different effect of risk factors on AL across EDs) components.RESULTS: Less-educated men (mean AL difference: 0.68, 95% CI 0.57 to 0.79) and women (1.52, 95% CI 1.40 to 1.64) had higher AL scores. DE accounted for 7% and 6% of the gradient in men and women, respectively. In men, combining smoking and alcohol intake, DS accounted for 42% of the gradient (smoking DS coefficient=0.177, 26% of the gradient; alcohol DS coefficient=0.109; 16%, not statistically significant). DS contribution increased to 69% in metabolic markers. DS estimates were consistent across age groups, irrespective of comorbidities and robust to unmeasured confounding. No DS was observed in women.CONCLUSIONS: In men, a DS mechanism substantially contributes to the educational class gradient in allostatic load.

AB - BACKGROUND: We investigate whether socially disadvantaged individuals are more susceptible to the detrimental effects of smoking and alcohol intake on allostatic load (AL), a marker of physiological 'wear and tear', resulting from adaptation to chronic stress.METHODS: In a cross-sectional analysis, 27 019 men and 26 738 women aged 35-74 years were identified from 21 European cohorts in the BiomarCaRE consortium. We defined three educational classes (EDs) according to years of schooling and an AL score as the sum of z-scores of eight selected biomarkers from the cardiovascular, metabolic and inflammatory systems. We used the Oaxaca-Blinder decomposition to disentangle the ED gradient in AL score into the differential exposure (DE, attributable to different distribution of smoking and alcohol intake across EDs) and the differential susceptibility (DS, attributable to a different effect of risk factors on AL across EDs) components.RESULTS: Less-educated men (mean AL difference: 0.68, 95% CI 0.57 to 0.79) and women (1.52, 95% CI 1.40 to 1.64) had higher AL scores. DE accounted for 7% and 6% of the gradient in men and women, respectively. In men, combining smoking and alcohol intake, DS accounted for 42% of the gradient (smoking DS coefficient=0.177, 26% of the gradient; alcohol DS coefficient=0.109; 16%, not statistically significant). DS contribution increased to 69% in metabolic markers. DS estimates were consistent across age groups, irrespective of comorbidities and robust to unmeasured confounding. No DS was observed in women.CONCLUSIONS: In men, a DS mechanism substantially contributes to the educational class gradient in allostatic load.

KW - Alcohol Drinking/adverse effects

KW - Allostasis

KW - Cross-Sectional Studies

KW - Educational Status

KW - Europe

KW - European Continental Ancestry Group

KW - Female

KW - Humans

KW - Male

KW - Smoking/adverse effects

U2 - 10.1136/jech-2020-213946

DO - 10.1136/jech-2020-213946

M3 - SCORING: Journal article

C2 - 32855263

VL - 74

SP - 1008

EP - 1015

JO - J EPIDEMIOL COMMUN H

JF - J EPIDEMIOL COMMUN H

SN - 0143-005X

IS - 12

ER -