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.
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