A1 Refereed original research article in a scientific journal
Patterning of educational attainment across inflammatory markers: Findings from a multi-cohort study
Authors: Marine Maurel, Raphaële Castagné, Eloïse Berger, Murielle Bochud, Marc Chadeau-Hyam, Silvia Fraga, Martina Gandini, Nina Hutri-Kähönen, Sirpa Jalkanen, Mika Kivimäki, Michael Marmot, Cathal McCrory, Martin Preisig, Olli Raitakari, Fulvio Ricceri, Marko Salmi, Andrew Steptoe, Paolo Vineis, Cyrille Delpierre, Michelle Kelly-Irving
Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE
Publication year: 2020
Journal: Brain, Behavior, and Immunity
Journal name in source: BRAIN BEHAVIOR AND IMMUNITY
Journal acronym: BRAIN BEHAV IMMUN
Volume: 90
First page : 303
Last page: 310
Number of pages: 8
ISSN: 0889-1591
eISSN: 1090-2139
DOI: https://doi.org/10.1016/j.bbi.2020.09.002(external)
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/50422228(external)
Background: Evidence suggests that the inflammatory reaction, an adaptive response triggered by a variety of harmful stimuli and conditions involved in the risk and development of many chronic diseases, is a potential pathway through which the socioeconomic environment is biologically embedded. Difficulty in interpreting the role of the inflammatory system in the embodiment dynamic arises because of heterogeneity across studies that use a limited but varied number of inflammatory markers. There is no consensus in the literature as to which inflammatory markers beyond the C-reactive protein and to a lesser extent interleukin 6 are related to the social environment. Accordingly, we aimed to investigate the association between educational attainment, and several markers of inflammation - C-reactive protein, fibrinogen, interleukin 6, interleukin 1 beta and tumor necrosis factor alpha- in 6 European cohort studies.Methods: Up to 17,470 participants from six European cohort studies with data on educational attainment, health behaviors and lifestyle factors, and at least two different inflammatory markers. Four sub-datasets were drawn with varying numbers of participants to allow pairwise comparison of the social patterning of C-reactive protein and any other inflammatory markers. To evaluate within each sub-dataset the importance of the context and cohort specificities, linear regression-based analyses were performed separately for each cohort and combined in a random effect meta-analysis to determine the relationship between educational attainment and inflammation.Results: We found that the magnitude of the relationship between educational attainment and five inflammatory biomarkers (C-reactive protein, fibrinogen, interleukin 6 and 1 beta and tumor necrosis factor alpha) was variable. By far the most socially patterned biomarker was C-reactive protein, followed by fibrinogen and to lesser extent interleukin 6, where a low educational attainment was associated with higher inflammation even after adjusting for health behaviours and body mass index. No association was found with interleukin 1 beta and tumor necrosis factor alpha.Conclusions: Our study suggests different educational patterning of inflammatory biomarkers. Further large-scale research is needed to explore social differences in the inflammatory cascade in greater detail and the extent to which these differences contribute to social inequalities in health.
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