Educational Disparities in Risk for Metabolic Syndrome

Insub Kim; Yun-Mi Song; Hyeonyoung Ko; Joohon Sung; Kayoung Lee; Jinyoung Shin; Sujeong Shin

doi:10.1089/met.2017.0170

Educational Disparities in Risk for Metabolic Syndrome

Metab Syndr Relat Disord. 2018 Oct;16(8):416-424. doi: 10.1089/met.2017.0170. Epub 2018 Jul 5.

Authors

Insub Kim¹, Yun-Mi Song¹, Hyeonyoung Ko², Joohon Sung³, Kayoung Lee⁴, Jinyoung Shin⁵, Sujeong Shin¹

Affiliations

¹ 1 Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, South Korea .
² 2 Health Promotion Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul, South Korea .
³ 3 Department of Epidemiology, School of Public Health and Institute of Health Environment, Seoul National University , Seoul, South Korea .
⁴ 4 Department of Family Medicine, Busan Paik Hospital, Inje University , College of Medicine, Busan, South Korea .
⁵ 5 Department of Family Medicine, Konkuk University Medical Center , Seoul, South Korea .

PMID: 29975597
DOI: 10.1089/met.2017.0170

Abstract

Background: The objective of this study was to evaluate the relationship between educational level as a surrogate marker of socioeconomic status and the risk of developing metabolic syndrome (MetS).

Methods: Study subjects were 1915 Korean adults (1193 women and 722 men) who participated in a cohort study. Educational level was categorized into two groups: (1) high education (more than 12 years of education), and (2) low education (less than 12 years of education). MetS was defined according to diagnostic criteria of the National Cholesterol Education Program (NCEP-III) and the International Diabetes Federation (IDF). Multiple logistic regression analysis and Cox proportional hazard analysis were performed to evaluate cross-sectional and prospective association between MetS or MetS components and educational level after adjusting for covariates.

Results: The overall prevalence of MetS at baseline was 15.0% in women and 20.4% in men. Incidence of MetS over 4.52 years was 16.6 per 1000 person-year in women and 27.6 per 1000 person-year in men. The prevalence and incidence of MetS were higher in the low educational group than those in the high educational group in both sexes. At baseline, the risk of MetS (odds ratio [OR]: 1.63, 95% confidence interval [CI]: 1.05-2.53 for NCEP criteria; OR: 2.30, 95% CI: 1.41-3.76 for IDF criteria) and abdominal obesity (OR: 2.62, 95% CI: 1.75-3.93) were higher in less educated women compared with those in more educated women. In men, there was no association between Mets or MetS components and educational level. Over 4.6 years of follow-up, the risk of developing MetS in women in the low education group (hazard ratio [HR]: 1.95, 95% CI: 1.12-3.50 for NCEP criteria; HR: 2.36, 95% CI: 1.14-4.86 for IDF criteria) was significantly higher than that in the high education group. In men, low education significantly increased the risk of developing impaired fasting glucose (HR: 1.95, 95% CI: 1.12-3.40).

Conclusion: An inverse association between educational level and MetS was found in Korean women, suggesting that socioeconomic disparities might increase the risk of MetS development, especially in women.

Keywords: educational level; metabolic syndrome; socioeconomic status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cross-Sectional Studies
Educational Status*
Female
Health Status Disparities*
Humans
Incidence
Male
Metabolic Syndrome / diagnosis
Metabolic Syndrome / epidemiology*
Middle Aged
Prevalence
Prospective Studies
Risk Assessment
Risk Factors
Seoul / epidemiology
Sex Factors
Social Determinants of Health*
Time Factors