Systemic Inflammation Contributes to the Association Between Childhood Socioeconomic Disadvantage and Midlife Cardiometabolic Risk

Abstract

Background: Childhood socioeconomic disadvantage is associated with increased risk for chronic inflammation and cardiometabolic disease at midlife.

Purpose: As it is presently unknown whether inflammation mediates the relationship between childhood socioeconomic status (SES) and adulthood cardiometabolic risk, we investigated associations between retrospectively reported childhood SES, circulating levels of inflammatory markers, and a latent construct of cardiometabolic risk in midlife adults.

Methods: Participants were 1,359 healthy adults aged 30-54 (Adult Health and Behavior Iⅈ 52% women, 17% Black) who retrospectively reported childhood SES (parental education, occupational grade). Measures included plasma interleukin (IL)-6, C-reactive protein (CRP), and cardiometabolic risk factors. Structural equation modeling was conducted, with cardiometabolic risk modeled as a second-order latent variable with adiposity, blood lipids, glucose control, and blood pressure as first-order components.

Results: Lower childhood SES was associated with greater risk for cardiometabolic disease at midlife (β = -0.08, CI[-0.04, -0.01], p = .01) in models adjusted for demographics, but this association was attenuated in models that adjusted for adulthood SES and health behaviors. In fully-adjusted models, the relationship between lower childhood SES and adult cardiometabolic risk was partially explained by higher circulating levels of CRP (β = -0.05, CI[-0.02, -0.01], p = .001), but not by IL-6. In an exploratory model, lower adulthood SES was also found to independently contribute to the association between childhood SES and adult cardiometabolic risk (β = -0.02, CI[-0.01, -0.001], p = .02).

Conclusions: The current study provides initial evidence that systemic inflammation may contribute to childhood socioeconomic disparities in cardiometabolic risk in midlife. Future work would benefit from prospective investigation of these relationships.

Keywords: Cardiometabolic health; Childhood socioeconomic disadvantage; Inflammation.

Fig. 1.

Direct (c′), indirect (ab), and total (c) effects of childhood SES on cardiometabolic risk via IL-6 and CRP, adjusted for demographic characteristics, adulthood SES, and adult health behaviors. Significant estimates are indicated by bold paths and asterisked effect sizes.

Fig. 2.

Model 3 expanded to include indirect effects via adulthood SES, adjusted for demographic characteristics and adult health behaviors. Significant estimates are indicated by bold paths and asterisked effect sizes.