Article Text
Abstract
Objectives In the present study, we examined the relation between socioeconomic status (SES) and the physiological distribution of iron-related blood parameters.
Design This is a cross-sectional analysis of longitudinal population-based cohort study.
Setting Based on a sample of healthy participants from a German research centre, various blood parameters and values of clinical examinations and questionnaires were collected.
Participants A total of 1206 healthy volunteers aged 2.5 to 19 years, one child per family randomly selected, were included.
Primary and secondary outcome measures Associations between the SES of children by Winkler-Stolzenberg Index (WSI) and its dimensions (income, education, occupation) and iron-related blood parameters (haemoglobin, ferritin and transferrin) were analysed by linear regression analyses. Gender and pubertal stage were included as covariables. Additionally, associations between SES of children by WSI and physical activity (side-to-side jumps, push-ups) as well as body mass index (BMI) were analysed by linear regression analyses.
Results Children with high WSI or family income showed significantly increased z-scores for haemoglobin (P=0.046; P<0.001). Children with increased WSI or family income showed significantly lower z-scores for transferrin (P<0.001). There was a significant correlation between haemoglobin and gender (P<0.001) and between transferrin and pubertal stage (P=0.024). Furthermore, physical activity was positively correlated and BMI was negatively correlated with WSI (P<0.001).
Discussion Our data show an association between SES and the distribution of iron-dependent parameters. Lower SES is correlated with lower values for haemoglobin and higher values for transferrin. Furthermore, we demonstrate that physical activity and BMI are associated with SES. Whereas higher SES is correlated with higher values for physical activity and lower BMI. Our parameters are standardised as z-scores with the advantages that the results are comparable across different age groups and present physiological courses.
Trial registration number NCT02550236; Results.
- childhealth
- socioeconomic status
- life child
- physiological distribution
- childcohort
- health inequality
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Footnotes
Contributors The data analysis and production of the manuscript were done by KR in collaboration with MV and CE with respect to statistics; with UC and KH with respect to laboratory medicine; with HL and MR with respect to medical sociology; with UW and WK with respect to pediatrics. All authors are responsible for the entire contents of this article and have approved the submission of the manuscript.
Funding This work was supported by LIFE (Leipzig Research Center for Civilization Diseases). LIFE is funded by the European Union through the European Regional Development Fund (ERDF) and by the Free State of Saxony under the State Excellence Initiative. This is an interdisciplinary project. We acknowledge support from the German Research Foundation (DFG) andLeipzig University within the program of Open Access Publishing acknowledge support from the German Research Foundation (DFG) andLeipzig University within the program of Open Access Publishing.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval Ethical Committee at the Medical Faculty, Leipzig University (Reg. no 264-10-19042010).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The statistical code and dataset are available from the corresponding author. A list of the approved assessments of the LIFE Child Study, which partly contains additional unpublished data, is inserted in the supplementary files.