Laitinen, TT and Puolakka, E and Ruohonen, S and Magnussen, CG and Smith, KJ and Viikari, JSA and Heinonen, OJ and Kartiosuo, N and Hutri-Kahonen, N and Kahonen, M and Jokinen, E and Laitinen, TP and Tossavainen, P and Pulkki-Raback, L and Elovainio, M and Raitakari, OT and Pahkala, K and Juonala, M, Association of socioeconomic status in childhood with left ventricular structure and diastolic function in adulthood: the cardiovascular risk in Young Finns Study, JAMA Pediatrics, 171, (8) pp. 781-787. ISSN 2168-6203 (2017) [Refereed Article]
Copyright 2017 American Medical Association
Objective: To examine whether family SES in childhood was associated with LV mass and diastolic function after adjustment for conventional cardiovascular disease risk factors in childhood and adulthood.
Design, Setting, and Participants: The analyses were performed in 2016 using data gathered in 1980 and 2011 within the longitudinal population-based Cardiovascular Risk in Young Finns Study. The sample comprised 1871 participants who reported family SES at ages 3 to 18 years and were evaluated for LV structure and function 31 years later.
Exposures: Socioeconomic status was characterized as annual income of the family and classified on a 3-point scale.
Main Outcomes and Measures: Left ventricular mass indexed according to height at the allometric power of 2.7 and the E/e' ratio describing LV diastolic performance at ages 34 to 49 years.
Results: The participants were aged 3 to 18 years at baseline (mean [SD], 10.8 [5.0] years), and the length of follow-up was 31 years. Family SES was inversely associated with LV mass (mean [SD] LV mass index, 31.8 [6.7], 31.0 [6.6], and 30.1 [6.4] g/m2.7 in the low, medium, and high SES groups, respectively; differences [95% CI], 1.7 [0.6 to 2.8] for low vs high SES; 0.8 [-0.3 to 1.9] for low vs medium; and 0.9 [0.1 to 1.6] for medium vs high; overall P = .001) and E/e' ratio (mean [SD] E/e' ratio, 5.0 [1.0], 4.9 [1.0], and 4.7 [1.0] in the low, medium, and high SES groups, respectively; differences [95% CI], 0.3 [0.1 to 0.4] for low vs high SES; 0.1 [-0.1 to 0.3] for low vs medium; and 0.2 [0 to 0.3] for medium vs high; overall P < .001) in adulthood. After adjustment for age, sex, and conventional cardiovascular disease risk factors in childhood and adulthood, and participants' own SES in adulthood, the relationship with LV mass (differences [95% CI], 1.5 [0.2 to 2.8] for low vs high SES; 1.3 [0 to 2.6] for low vs medium; and 0.2 [-0.6 to 1.0] for medium vs high; P = .03) and E/e' ratio (differences [95% CI], 0.2 [0 to 0.5] for low vs high SES; 0.1 [-0.1 to 0.4] for low vs medium; and 0.1 [0 to 0.3] for medium vs high; P = .02) remained significant.
Conclusions and Relevance: Low family SES was associated with increased LV mass and impaired diastolic performance more than 3 decades later. These findings emphasize that approaches of cardiovascular disease prevention must be directed also to the family environment of the developing child.
|Item Type:||Refereed Article|
|Keywords:||socioeconomic status, ventricular structure, diastolic function, longitudinal|
|Research Division:||Health Sciences|
|Research Field:||Epidemiology not elsewhere classified|
|Objective Group:||Public health (excl. specific population health)|
|Objective Field:||Preventive medicine|
|UTAS Author:||Magnussen, CG (Associate Professor Costan Magnussen)|
|UTAS Author:||Smith, KJ (Dr Kylie Smith)|
|Web of Science® Times Cited:||8|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||110 View Download Statistics|
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