Metabolic profiles of socio-economic position: a multi-cohort analysis.

Oliver Robinson,Nishi Chaturvedi,Tina Shah,Diana Kuh,Jorgen Engmann,Laura D Howe,Therese Tillin,Andrew Wong,Alice R Carter,Usha Menon,Terho Lehtimäki,Reecha Sofat,Julie Taylor,Chung-Ho E Lau,Mika Kähönen,Ville Karhunen,Jorma Viikari,Andy Ryan,Mika Kivimäki,Stephanie Smith,Aroon D Hingorani ,Yoav Ben‐Shlomo ,Marjo‐Riitta Järvelin ,Rui Providência ,Juan P Casas ,Alun D Hughes ,Olli T Raitakari ,Mika Ala‐Korpela ,Paolo Víneis

doi:10.1093/ije/dyaa188

Abstract

BackgroundLow socio-economic position (SEP) is a risk factor for multiple health outcomes, but its molecular imprints in the body remain unclear.MethodsWe examined SEP as a determinant of serum nuclear magnetic resonance metabolic profiles in ∼30 000 adults and 4000 children across 10 UK and Finnish cohort studies.ResultsIn risk-factor-adjusted analysis of 233 metabolic measures, low educational attainment was associated with 37 measures including higher levels of triglycerides in small high-density lipoproteins (HDL) and lower levels of docosahexaenoic acid (DHA), omega-3 fatty acids, apolipoprotein A1, large and very large HDL particles (including levels of their respective lipid constituents) and cholesterol measures across different density lipoproteins. Among adults whose father worked in manual occupations, associations with apolipoprotein A1, large and very large HDL particles and HDL-2 cholesterol remained after adjustment for SEP in later life. Among manual workers, levels of glutamine were higher compared with non-manual workers. All three indicators of low SEP were associated with lower DHA, omega-3 fatty acids and HDL diameter. At all ages, children of manual workers had lower levels of DHA as a proportion of total fatty acids.ConclusionsOur work indicates that social and economic factors have a measurable impact on human physiology. Lower SEP was independently associated with a generally unfavourable metabolic profile, consistent across ages and cohorts. The metabolites we found to be associated with SEP, including DHA, are known to predict cardiovascular disease and cognitive decline in later life and may contribute to health inequalities.

Highlights

Disadvantaged socio-economic position (SEP) is associated with increased risk of mortality and morbidity, including cardiovascular disease (CVD), diabetes, cancers and frailty, based on extensive and robust evidence.[1,2]the gradient in SEP and health is only partly explained by intermediate risk factors.[1,2] Recently, research using biomarkers has explored the biological mechanisms through which SEP may get ‘under the skin’ and influence disease risk
The study included six British cohorts participating in the UCL-LSHTM-Edinburgh-Bristol (UCLEB) Consortium[22]: the MRC National Survey of Health and Development (NSHD), the Caerphilly Prospective Study (CaPS), the British Women’s Heart and Health Study (BWHHS), the Southall and Brent Revisited Study (SABRE), the Whitehall-II study (WHII) and the UK Collaborative Trial of Ovarian Cancer Screening Longitudinal Women’s Cohort (UKCTOCS)
In an analysis of almost 30 000 adults across 10 UK and Finnish cohorts, we observed that SEP has a strong association with the serum nuclear magnetic resonance spectroscopy (NMR) metabolome

Summary

Introduction

Disadvantaged socio-economic position (SEP) is associated with increased risk of mortality and morbidity, including cardiovascular disease (CVD), diabetes, cancers and frailty, based on extensive and robust evidence.[1,2]the gradient in SEP and health is only partly explained by intermediate risk factors (e.g. smoking and adiposity).[1,2] Recently, research using biomarkers has explored the biological mechanisms through which SEP may get ‘under the skin’ and influence disease risk. Low socio-economic position (SEP) is a risk factor for multiple health outcomes, but its molecular imprints in the body remain unclear. Results: In risk-factor-adjusted analysis of 233 metabolic measures, low educational attainment was associated with 37 measures including higher levels of triglycerides in small high-density lipoproteins (HDL) and lower levels of docosahexaenoic acid (DHA), omega-3 fatty acids, apolipoprotein A1, large and very large HDL particles (including levels of their respective lipid constituents) and cholesterol measures across different density lipoproteins. Among adults whose father worked in manual occupations, associations with apolipoprotein A1, large and very large HDL particles and HDL-2 cholesterol remained after adjustment for SEP in later life. All three indicators of low SEP were associated with lower DHA, omega-3 fatty acids and HDL diameter. The metabolites we found to be associated with SEP, including DHA, are known to predict cardiovascular disease and cognitive decline in later life and may contribute to health inequalities

Methods

Results

Conclusion