Relative contribution of health-related behaviours and chronic diseases to the socioeconomic patterning of low-grade inflammation

Int J Public Health. 2017 Jun;62(5):551-562. doi: 10.1007/s00038-016-0939-0. Epub 2017 Jan 21.

Abstract

Objectives: To test the association of low-grade inflammation with socioeconomic status (SES) and determine the relative contribution of prevalent chronic diseases and health-related behaviours in explaining such association.

Methods: Cross-sectional analysis on 19,867 subjects (age ≥35, 48.1% men) recruited within the Moli-sani study from 2005 to 2010 (Italy). A score of low-grade inflammation, including platelet and leukocyte counts, the granulocyte-to-lymphocyte ratio, and C-reactive protein was applied. SES was measured by education, household income, and occupational social class.

Results: Low SES was associated with elevated levels of low-grade inflammation. Health behaviours (including adiposity, smoking, physical activity, and Mediterranean diet adherence) explained 53.5, 53.9, and 84.9% of the association between social class, income, and education with low-grade inflammation, respectively. Adiposity and body mass index showed a prominent role, while prevalent chronic diseases and conditions only marginally attenuated SES inequalities in inflammation.

Conclusions: Low-grade inflammation was socioeconomically patterned in a large Mediterranean population. Potentially modifiable behavioural factors explained the greatest part of this association with a leading contribution of adiposity, body mass index, and physical activity.

Keywords: Chronic diseases; Health-related behaviours; Low-grade inflammation; Moli-sani study; Socioeconomic status.

MeSH terms

  • Adiposity
  • Adult
  • Aged
  • Biomarkers / analysis
  • Body Mass Index
  • Chronic Disease / epidemiology*
  • Cross-Sectional Studies
  • Diet, Mediterranean
  • Exercise
  • Female
  • Health Behavior*
  • Humans
  • Inflammation / epidemiology*
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Smoking
  • Social Class*

Substances

  • Biomarkers