Archives of the Turkish Society of Cardiology
Family income in shaping cardiometabolic risk profile: a prospective analysis including gender-related differences [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2006; 34(8): 471-478

Family income in shaping cardiometabolic risk profile: a prospective analysis including gender-related differences

Altan Onat1, Hakan Özhan3, Günay Can2, Gülay Hergenç4, Ahmet Karabulut5, Sinan Albayrak3
1Turkish Society of Cardiology, Istanbul, Turkey
2Istanbul University, Cerrahpaşa Medical Faculty, Department of Cardiology, Istanbul
3Abant Izzet Baysal University, Düzce Medical Faculty, Department of Cardiology, Düzce
4Yıldız Tecnical University, Department of Biology, Istanbul, Turkey
5Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey


OBJECTIVES
We investigated the extent to which family income predicts smoking, metabolic syndrome (MS) and its components, elevated levels of apolipoprotein (hyperapo) B and C-reactive protein (CRP), and incident coronary heart disease (CHD), with reference to gender-related differences.

STUDY DESIGN
A total of 3,273 participants (1610 males, 1630 females; mean age 48.3±12 years, minimum age 28 years) of the TEKHARF surveys 1997/98 and 2002/03 were prospectively evaluated during a mean of 5.9 years. Monthly family incomes were grouped into four categories. Elevated apoB and CRP levels were based on the cutoff values of 120 mg/dl and 3 mg/l, respectively. Identification of MS was made according to the Adult Treatment Panel III criteria modified by the TEKHARF study. Diagnosis of CHD was based on history, physical examination, and the Minnesota coding of resting electrocardiograms.

RESULTS
In age-adjusted logistic regression analyses, men with higher income brackets had an increased incidence of diabetes, hypertension, and elevated hyperapo B. In women, income was positively associated with smoking and elevated hyperapo B, and inversely related with obesity, abdominal obesity, and - at borderline significance - triglyceride/HDL dyslipidemia; diabetes and hypertension were not predicted by income. Lower income brackets (<910 NTL) predicted elevated CRP levels in both genders (relative risk 1.47, p<0.002). Income exhibited an insignificant relative risk (1.27) for incident CHD.

CONCLUSION
The level of family income contributes to the development of an adverse risk profile in Turks. Given increased smoking in women and its inhibitory effect on (abdominal) obesity, rising income seems to predict improvement in some elements of the cardiometabolic risk profile.

Keywords: Coronary disease/epidemiology, C-reactive protein, dyslipidemias, health surveys; income/classification; metabolic syndrome X; risk factors; smoking; socioeconomic factors

How to cite this article
Altan Onat, Hakan Özhan, Günay Can, Gülay Hergenç, Ahmet Karabulut, Sinan Albayrak. Family income in shaping cardiometabolic risk profile: a prospective analysis including gender-related differences. Turk Kardiyol Dern Ars. 2006; 34(8): 471-478

Corresponding Author: Altan Onat, Türkiye
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