Life course socioeconomic trajectories and c-reactive protein levels in young adults: Findings from a Brazilian birth cohort

Objective

To examine the association between lifecourse socioeconomic factors and C-reactive protein levels in young adults in a middle-income setting

Design

Population-based birth cohort (n=5914)

Main outcome measure

Circulating C-reactive protein levels

Methods

The impact of family income at birth, maternal education, current family income and own education on C-reactive protein levels at age 23 years was investigated in 3827 cohort members based on a hierarchical conceptual model.

Results

In women, maternal education was inversely associated with C-reactive protein levels after adjustment for current education and income (p=0.01). This association was null when adjusted for adult BMI. Other socioeconomic indicators were not associated. In men, family income at birth was directly associated with C-reactive protein levels. Estimates were attenuated when potential mediators were adjusted for, but remained significant (p=0.02). Maternal education showed no association in men in crude analyses, but after adjustment for income and current variables, an inverse association became apparent. Wealthier men with low attained education had the highest C-reactive protein levels.

Conclusions Socioeconomic conditions at birth showed lasting associations with C-reactive protein levels; maternal education showed protective associations in both sexes whereas family income at birth was a risk factor in men. C-reactive protein levels mirrored obesity patterns from middle-income settings where rich men and poor women are most affected. Public health strategies should not overlook the importance of social determinants of chronic disease, especially in regions undergoing the epidemiological transition.