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Socioeconomic status, sex linked to differences in cholesterol levels
Total cholesterol levels were associated with occupational level in men and educational level in women, according to results of a prospective population-based study.
Researchers studied the lipid levels of participants in the European Prospective Investigation into Cancer (EPIC-Norfolk) study of 10,147 men and 12,304 women aged 45 to 80 years from Norfolk, United Kingdom.
Plasma levels of cholesterol and triglycerides were taken from participants at baseline. From questionnaire responses, researchers stratified participants by social class according to occupation, educational level and area deprivation score according to Townsend deprivation index.
Kay-Tee Khaw, MA, MBBChir, MSc, and colleagues quantified differences in lipid levels by socioeconomic status through analysis of variance and multiple linear regression after adjustment for BMI and alcohol consumption.
Khaw, from the University of Cambridge, and colleagues found that there was no association between total cholesterol and any of the three social classification methods in men, but when they were stratified by manual vs. non-manual professions, those in manual professions were more likely to have elevated total cholesterol compared with those in non-manual professions, even after adjustment for age (regression coefficient, –0.055; 95% CI, –0.1 to –0.01) or age and BMI (regression coefficient, –0.058; 95% CI, –0.1 to 0.01).
For women, the researchers found, total cholesterol levels were not associated with occupation-based class or deprivation category, but women with a lower educational level were more likely to have high total cholesterol than those with a higher educational level, even after adjustment for age and BMI (regression coefficient, 0.077; 95% CI, 0.035-0.12).
Triglyceride levels were not associated with socioeconomic status in men, but they were associated with lower socioeconomic status in women according to all three measures, and remained significant for occupational class and educational level after adjustment for age and BMI, Khaw and colleagues wrote.
HDL levels were not associated with socioeconomic status in men after adjustment for age, BMI and alcohol intake, but women with lower educational level were more likely than those with higher educational level to have lower HDL levels (P<.001), the researchers found.
LDL levels were not associated with socioeconomic status in men, but women with lower educational level were more likely than those with higher educational level to have higher LDL levels (P<.001), they found.
“The association of some adverse lipid parameters with social class and, in particular, educational status in women was much stronger than for men,” Khaw said in a press release. “If we wish to reduce health inequalities, we need to understand the reason for these health inequalities. Future studies need to look at men and women separately and explore the reasons for these sex differences.”
Disclosure: The researchers report no relevant financial disclosures.