Adverse Psychosocial, socioeconomic, and developmental processes and risk of inflammation and type 2 diabetes mellitus in later life
Research output: Book/Report › Ph.D. thesis
Introduction: Identifying risk factors for inflammation and type II diabetes mellitus (T2DM) at different times over life could help to inform on prevention strategies aimed at reducing the later monetary and human cost associated with T2DM and inflammatory mediated diseases. Aim: The overall objective of the thesis was to explore socioeconomic, psychosocial and developmental risk factors in relation to inflammation and T2DM. In terms of developmental risk factors I addressed how body weight within and across generations is associated with inflammation in late middle aged men and if there are socioeconomic differentials in these effects. To address psychosocial risk factors, I studied if the accumulation of major life events in childhood, adult private and work life were associated with T2DM and furthermore if there was evidence of differential vulnerability to these effects by socioeconomic position (SEP). To elucidate the mechanisms by which SEP is associated with inflammation, I studied how education, income and occupational prestige are associated with inflammation in postmenopausal women. Materials & Methods: This thesis is based on data from the Copenhagen Aging and Midlife Biobank, the Copenhagen City Heart Study and the Women’s Health Initiative-Observational Study. All three of the data sets included comprehensive life style, socioeconomic and health status measurements and a clinical examination. The two main statistical methods employed in this thesis are path analysis and multivariable logistic regression. Results: In study I, maternal pre-pregnancy-BMI was associated with offspring inflammation through its effect on offspring body weight in adult life. Higher body weight at birth was protective against later inflammation independently of adult body size however increases in body weight in adulthood were a risk factor for higher inflammation. There was some evidence of SEP differences in the effects of body weight at birth and adulthood and later inflammation. Studies II and III provide evidence that the accumulation of adverse psychosocial and socioeconomic conditions increase the risk of T2DM and inflammation. In study II, the accumulation of major life events in childhood, adult and private life was associated with T2DM and there was some evidence that individuals with a short education are more vulnerable to the effects of major life events in the childhood and work life domains than individuals with longer education. Study III suggests that the inverse association between education and CRP in postmenopausal women is primarily explained by the effect of education on both income and occupational prestige. There are inverse associations between income, occupational prestige and CRP that operate primarily independently of smoking and waist-hip ratio. Conclusions: These findings suggest that adverse body weight histories may contribute to inflammation. Further, the accumulation of adverse socioeconomic and psychosocial factors over life contributes to adverse inflammatory profiles and the development of T2DM.
|Publisher||Faculty of Health and Medical Sciences, University of Copenhagen|
|Number of pages||140|
|Publication status||Published - 2015|