Skip to main content
Top
Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

Gender, socio-economic status and metabolic syndrome in middle-aged and old adults

Published in: BMC Public Health | Issue 1/2008

Login to get access

Abstract

Background

Studies that addressed social and economic determinants of cardiovascular diseases, consistently showed an increase prevalence of the individual features of metabolic syndrome in the lower socio-economic strata. Thus, this study aimed to evaluate the association between social class and metabolic syndrome in a sample of urban middle-aged and old Portuguese adults.

Methods

We evaluated 1962 subjects (1207 women and 755 men) aged 40 or more years. Marital status, education, occupation, menarche age and height distribution were used as socioeconomic indicators. Metabolic syndrome was defined according to the ATP III, by the presence of at least three of the following characteristics: waist circumference >102 cm in men and >88 cm in women; triglycerides ≥ 150 mg/dl; HDL cholesterol <40 mg/dl in men and <50 mg/dl in women; blood pressure ≥ 130/85 mm Hg; and fasting glucose ≥ 110 mg/dl. Proportions were compared using the chi square test or Fisher's exact test. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using unconditional logistic regression to estimate the magnitude of the associations.

Results

Metabolic syndrome was significantly more frequent in females (24.9 vs. 17.4, p < 0.001). In females, the odds favoring metabolic syndrome significantly increased with age and in unfavorable social class as described by occupation, and decreased with education level. In males, metabolic syndrome was significantly more frequent in the 60–69 years age class (OR = 1.82; 95%CI: 1.02–3.26) when compared to those in the 40–49 years age class. Concerning other socioeconomic indicators no significant associations were found.

Conclusion

This study showed that gender influenced the association of socio-economic status indicators with metabolic syndrome. Females in lower social classes, as defined by education and occupational classification, more frequently presented metabolic syndrome, no such association was found in males.
Literature
1.
go back to reference Cameron AJ, Shaw JE, Zimmet PZ: The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin North Am. 2004, 33 (2): 351-375. 10.1016/j.ecl.2004.03.005.CrossRefPubMed Cameron AJ, Shaw JE, Zimmet PZ: The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin North Am. 2004, 33 (2): 351-375. 10.1016/j.ecl.2004.03.005.CrossRefPubMed
2.
go back to reference Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part I: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998, 15: 539-553. 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S.CrossRefPubMed Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part I: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998, 15: 539-553. 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S.CrossRefPubMed
3.
go back to reference Balkau B, Vernay M, Mhamdi L, Novak M, Arondel D, Vol S, Tichet J, Eschwège E, Group DESIRS: The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French DESIR study. Diabetes Metab. 2003, 29: 526-532. 10.1016/S1262-3636(07)70067-8.CrossRefPubMed Balkau B, Vernay M, Mhamdi L, Novak M, Arondel D, Vol S, Tichet J, Eschwège E, Group DESIRS: The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French DESIR study. Diabetes Metab. 2003, 29: 526-532. 10.1016/S1262-3636(07)70067-8.CrossRefPubMed
4.
go back to reference Lidfeldt J, Nyberg P, Nerbrand C, Samsioe G, Schersten B, Agardh CD: Socio-demographic and psychosocial factors are associated with features of the metabolic syndrome. The Women's Health in the Lund Area (WHILA) study. Diabetes Obes Metab. 2003, 5 (2): 106-112. 10.1046/j.1463-1326.2003.00250.x.CrossRefPubMed Lidfeldt J, Nyberg P, Nerbrand C, Samsioe G, Schersten B, Agardh CD: Socio-demographic and psychosocial factors are associated with features of the metabolic syndrome. The Women's Health in the Lund Area (WHILA) study. Diabetes Obes Metab. 2003, 5 (2): 106-112. 10.1046/j.1463-1326.2003.00250.x.CrossRefPubMed
5.
go back to reference Minehira K, Tappy L: Dietary and lifestyle interventions in the management of the metabolic syndrome: present status and future perspective. Eur J Clin Nutr. 2002, 56 (12): 1264-1269. 10.1038/sj.ejcn.1601645.CrossRef Minehira K, Tappy L: Dietary and lifestyle interventions in the management of the metabolic syndrome: present status and future perspective. Eur J Clin Nutr. 2002, 56 (12): 1264-1269. 10.1038/sj.ejcn.1601645.CrossRef
6.
go back to reference Regidor E, Gutierrez-Fisac JL, Banegas JR, Lopez-Garcia E, Rodriguez-Artalejo F: Obesity and socioeconomic position measured at three stages of the life course in the elderly. Eur J Clin Nutr. 2004, 58 (3): 488-494. 10.1038/sj.ejcn.1601835.CrossRefPubMed Regidor E, Gutierrez-Fisac JL, Banegas JR, Lopez-Garcia E, Rodriguez-Artalejo F: Obesity and socioeconomic position measured at three stages of the life course in the elderly. Eur J Clin Nutr. 2004, 58 (3): 488-494. 10.1038/sj.ejcn.1601835.CrossRefPubMed
7.
go back to reference Diez Roux AV, Chambless L, Merkin SS, Arnett D, Eigenbrodt M, Nieto FJ, Szklo M, Sorlie P: Socioeconomic disadvantage and change in blood pressure associated with aging. Circulation. 2002, 106 (6): 703-710. 10.1161/01.CIR.0000025402.84600.CD.CrossRefPubMed Diez Roux AV, Chambless L, Merkin SS, Arnett D, Eigenbrodt M, Nieto FJ, Szklo M, Sorlie P: Socioeconomic disadvantage and change in blood pressure associated with aging. Circulation. 2002, 106 (6): 703-710. 10.1161/01.CIR.0000025402.84600.CD.CrossRefPubMed
8.
go back to reference Myllykangas M, Pekkanen J, Rasi V, Haukkala A, Vahtera E, Salomaa V: Haemostatic and other cardiovascular risk factors, and socioeconomic status among middle-aged Finnish men and women. Int J Epidemiol. 1995, 24 (6): 1110-1116. 10.1093/ije/24.6.1110.CrossRefPubMed Myllykangas M, Pekkanen J, Rasi V, Haukkala A, Vahtera E, Salomaa V: Haemostatic and other cardiovascular risk factors, and socioeconomic status among middle-aged Finnish men and women. Int J Epidemiol. 1995, 24 (6): 1110-1116. 10.1093/ije/24.6.1110.CrossRefPubMed
9.
go back to reference Winkleby MA, Jatulis DE, Frank E, Fortmann SP: Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992, 82 (6): 816-820.CrossRefPubMedPubMedCentral Winkleby MA, Jatulis DE, Frank E, Fortmann SP: Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992, 82 (6): 816-820.CrossRefPubMedPubMedCentral
10.
go back to reference Lawlor DA, Ebrahim S, Davey Smith G: Socioeconomic position in childhood and adulthood and insulin resistance: cross sectional survey using data from British women's heart and health survey. BMJ. 2002, 325: 805-810. 10.1136/bmj.325.7368.805.CrossRefPubMedPubMedCentral Lawlor DA, Ebrahim S, Davey Smith G: Socioeconomic position in childhood and adulthood and insulin resistance: cross sectional survey using data from British women's heart and health survey. BMJ. 2002, 325: 805-810. 10.1136/bmj.325.7368.805.CrossRefPubMedPubMedCentral
11.
go back to reference Brunner E, Marmot MG, Nanchahal K, Shipley MJ, Stansfeld SA, Juneja M, Alberti KGMM: Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study. Diabetologia. 1997, 40: 1341-1349. 10.1007/s001250050830.CrossRefPubMed Brunner E, Marmot MG, Nanchahal K, Shipley MJ, Stansfeld SA, Juneja M, Alberti KGMM: Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study. Diabetologia. 1997, 40: 1341-1349. 10.1007/s001250050830.CrossRefPubMed
12.
go back to reference Arber S, Khlat M: Introduction to 'social and economic patterning of women's health in a changing world.'. Soc Sci Med. 2002, 54 (5): 643-647. 10.1016/S0277-9536(01)00114-9.CrossRefPubMed Arber S, Khlat M: Introduction to 'social and economic patterning of women's health in a changing world.'. Soc Sci Med. 2002, 54 (5): 643-647. 10.1016/S0277-9536(01)00114-9.CrossRefPubMed
13.
go back to reference Dallongeville J, Cottel D, Ferrieres J, Arveiler D, Bingham A, Ruidavets JB, Haas B, Ducimetiere P, Amouyel P: Household income is associated with the risk of metabolic syndrome in a sex-specific manner. Diabetes Care. 2005, 28 (2): 409-415. 10.2337/diacare.28.2.409.CrossRefPubMed Dallongeville J, Cottel D, Ferrieres J, Arveiler D, Bingham A, Ruidavets JB, Haas B, Ducimetiere P, Amouyel P: Household income is associated with the risk of metabolic syndrome in a sex-specific manner. Diabetes Care. 2005, 28 (2): 409-415. 10.2337/diacare.28.2.409.CrossRefPubMed
14.
go back to reference Langenberg C, Kuh D, Wadsworth MEJ, Brunner E, Hardy R: Social circumstances and education: life course origins of social inequalities in metabolic risk in a prospective National Birth Cohort. Am J Public Health. 2006, 96 (12): 2216-2221. 10.2105/AJPH.2004.049429.CrossRefPubMedPubMedCentral Langenberg C, Kuh D, Wadsworth MEJ, Brunner E, Hardy R: Social circumstances and education: life course origins of social inequalities in metabolic risk in a prospective National Birth Cohort. Am J Public Health. 2006, 96 (12): 2216-2221. 10.2105/AJPH.2004.049429.CrossRefPubMedPubMedCentral
15.
go back to reference Lawlor DA, Davey Smith G, Ebrahim S: Does the new International Diabetes Federation definition of metabolic syndrome predict CHD any more strongly than older definitions? Findings from the British Women's Heart and Health Study. Diabetologia. 2006, 49: 41-48. 10.1007/s00125-005-0040-3.CrossRefPubMed Lawlor DA, Davey Smith G, Ebrahim S: Does the new International Diabetes Federation definition of metabolic syndrome predict CHD any more strongly than older definitions? Findings from the British Women's Heart and Health Study. Diabetologia. 2006, 49: 41-48. 10.1007/s00125-005-0040-3.CrossRefPubMed
16.
go back to reference Ramos E, Lopes C, Barros H: Investigating the effect of nonparticipation using a population-based case-control study on myocardial infarction. Ann Epidemiol. 2004, 14: 437-441. 10.1016/j.annepidem.2003.09.013.CrossRefPubMed Ramos E, Lopes C, Barros H: Investigating the effect of nonparticipation using a population-based case-control study on myocardial infarction. Ann Epidemiol. 2004, 14: 437-441. 10.1016/j.annepidem.2003.09.013.CrossRefPubMed
17.
go back to reference Abramson J: Surveys methods in community medicine. An introduction to epidemiological and evaluative methods. 1989, London: Churchill Linvingstone, 3rd Edition Abramson J: Surveys methods in community medicine. An introduction to epidemiological and evaluative methods. 1989, London: Churchill Linvingstone, 3rd Edition
18.
go back to reference Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, et al: Human blood pressure determination by sphygmomanometry. Circulation. 1993, 88: 2460-2470.CrossRefPubMed Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, et al: Human blood pressure determination by sphygmomanometry. Circulation. 1993, 88: 2460-2470.CrossRefPubMed
19.
go back to reference Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef
20.
go back to reference Alberti KGMM, Zimmet P, Shaw J: Metabolic syndrome - a new world-wide definition. A consensus Statement from the International Diabetes Federation . Diabet Med. 2006, 23: 469-480. 10.1111/j.1464-5491.2006.01858.x.CrossRefPubMed Alberti KGMM, Zimmet P, Shaw J: Metabolic syndrome - a new world-wide definition. A consensus Statement from the International Diabetes Federation . Diabet Med. 2006, 23: 469-480. 10.1111/j.1464-5491.2006.01858.x.CrossRefPubMed
21.
go back to reference Horsten M, Mittleman MA, Wamala SP, Schenck-Gustafsson K, Orth-Gomer K: Social relations and the metabolic syndrome in middle-aged Swedish women. J Cardiovasc Risk. 1999, 6 (6): 391-397.CrossRefPubMed Horsten M, Mittleman MA, Wamala SP, Schenck-Gustafsson K, Orth-Gomer K: Social relations and the metabolic syndrome in middle-aged Swedish women. J Cardiovasc Risk. 1999, 6 (6): 391-397.CrossRefPubMed
22.
23.
go back to reference Mokdad AH, Ford ES, Bowman BA, Nelson DE, Engelgau MM, Vinicor F, Marks JS: Diabetes trends in the US: 1990-1998. Diabetes Care. 2000, 23: 1278-1283. 10.2337/diacare.23.9.1278.CrossRefPubMed Mokdad AH, Ford ES, Bowman BA, Nelson DE, Engelgau MM, Vinicor F, Marks JS: Diabetes trends in the US: 1990-1998. Diabetes Care. 2000, 23: 1278-1283. 10.2337/diacare.23.9.1278.CrossRefPubMed
24.
go back to reference Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP: The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001, 286: 1195-1200. 10.1001/jama.286.10.1195.CrossRefPubMed Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP: The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001, 286: 1195-1200. 10.1001/jama.286.10.1195.CrossRefPubMed
25.
go back to reference Robbins JM, Vaccarino V, Zhang H, Kasl SV: Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the Third National Health and Nutrition Examination Survey . Am J Public Health. 2001, 91: 76-83.CrossRefPubMedPubMedCentral Robbins JM, Vaccarino V, Zhang H, Kasl SV: Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the Third National Health and Nutrition Examination Survey . Am J Public Health. 2001, 91: 76-83.CrossRefPubMedPubMedCentral
26.
go back to reference Direcção Geral da Saúde: Risco de Morrer em Portugal, 2001. 2003, Lisboa , DGS, 232- Direcção Geral da Saúde: Risco de Morrer em Portugal, 2001. 2003, Lisboa , DGS, 232-
27.
go back to reference Santos AC, Lopes C, Barros H: Prevalence of metabolic syndrome in the city of Porto. Rev Port Cardiol. 2004, 23 (1): 45-52.PubMed Santos AC, Lopes C, Barros H: Prevalence of metabolic syndrome in the city of Porto. Rev Port Cardiol. 2004, 23 (1): 45-52.PubMed
28.
go back to reference Padez C: Secular trends in stature in the Portuguese population (1904-2000). Ann Human Biology. 2003, 30: 262-278. 10.1080/0301446031000064530.CrossRef Padez C: Secular trends in stature in the Portuguese population (1904-2000). Ann Human Biology. 2003, 30: 262-278. 10.1080/0301446031000064530.CrossRef
29.
go back to reference de Castro JJ, Aleixo Dias J, Baptista F, Garcia e Costa J, Galvao-Teles A, Camilo-Alves A: Secular trends of weight, height and obesity in cohorts of young Portuguese males in the District of Lisbon: 1960-1990. Eur J Epidemiol. 1998, 14 (3): 299-303. 10.1023/A:1007411710094.CrossRefPubMed de Castro JJ, Aleixo Dias J, Baptista F, Garcia e Costa J, Galvao-Teles A, Camilo-Alves A: Secular trends of weight, height and obesity in cohorts of young Portuguese males in the District of Lisbon: 1960-1990. Eur J Epidemiol. 1998, 14 (3): 299-303. 10.1023/A:1007411710094.CrossRefPubMed
30.
go back to reference Krieger N, Williams DR, Moss NE: Measuring social class in US Public Health Research: Concepts, Methodologies, and Guidelines. Annual Review of Public Health. 1997, 18 (1): 341-378. 10.1146/annurev.publhealth.18.1.341.CrossRefPubMed Krieger N, Williams DR, Moss NE: Measuring social class in US Public Health Research: Concepts, Methodologies, and Guidelines. Annual Review of Public Health. 1997, 18 (1): 341-378. 10.1146/annurev.publhealth.18.1.341.CrossRefPubMed
31.
go back to reference Wamala SP, Linch J, Horsten M, Mittleman MA, Schenck-Gustafsson K, Orth-Gomér K: Education and the metabolic syndrome in women. Diabetes Care. 1999, 22: 1999-2003. 10.2337/diacare.22.12.1999.CrossRefPubMed Wamala SP, Linch J, Horsten M, Mittleman MA, Schenck-Gustafsson K, Orth-Gomér K: Education and the metabolic syndrome in women. Diabetes Care. 1999, 22: 1999-2003. 10.2337/diacare.22.12.1999.CrossRefPubMed
32.
go back to reference Kim MH, Kim MK, Choi BY, Shin YJ: Educational disparities in the metabolic syndrome in a rapidly changing society - the case of South Korea. Int J Epidemiol. 2005, 34: 1266-1273. 10.1093/ije/dyi175.CrossRefPubMed Kim MH, Kim MK, Choi BY, Shin YJ: Educational disparities in the metabolic syndrome in a rapidly changing society - the case of South Korea. Int J Epidemiol. 2005, 34: 1266-1273. 10.1093/ije/dyi175.CrossRefPubMed
33.
go back to reference Stelmach W, Kaczmarczyk-Chalas K, Bielecki W, Drygas W: How education, income, control over life and life style contribute to risk factors for cardiovascular disease among adults in a post-communist country. Public Health. 2005, 119 (6): 498-508. 10.1016/j.puhe.2004.09.006.CrossRefPubMed Stelmach W, Kaczmarczyk-Chalas K, Bielecki W, Drygas W: How education, income, control over life and life style contribute to risk factors for cardiovascular disease among adults in a post-communist country. Public Health. 2005, 119 (6): 498-508. 10.1016/j.puhe.2004.09.006.CrossRefPubMed
34.
go back to reference Choiniere R, Lafontaine P, Edwards AC: Distribution of cardiovascular disease risk factors by socioeconomic status among Canadian adults. CMAJ. 2000, 162 (9 Suppl): S13-24.PubMedPubMedCentral Choiniere R, Lafontaine P, Edwards AC: Distribution of cardiovascular disease risk factors by socioeconomic status among Canadian adults. CMAJ. 2000, 162 (9 Suppl): S13-24.PubMedPubMedCentral
35.
go back to reference Santos AC, Ebrahim S, Barros H: Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome. Prev Med. 2007, 44: 328-334. 10.1016/j.ypmed.2006.11.016.CrossRefPubMed Santos AC, Ebrahim S, Barros H: Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome. Prev Med. 2007, 44: 328-334. 10.1016/j.ypmed.2006.11.016.CrossRefPubMed
36.
go back to reference Kannam JP, Levy D, Larson M, Wilson PW: Short stature and risk for mortality and cardiovascular disease events. The Framingham Heart Study. Circulation. 1994, 90 (5): 2241-2247.CrossRefPubMed Kannam JP, Levy D, Larson M, Wilson PW: Short stature and risk for mortality and cardiovascular disease events. The Framingham Heart Study. Circulation. 1994, 90 (5): 2241-2247.CrossRefPubMed
37.
go back to reference Samaras TT, Storms LH: Secular growth and its harmful ramifications. Medical Hypotheses. 2002, 58 (2): 93-112. 10.1054/mehy.2001.1463.CrossRefPubMed Samaras TT, Storms LH: Secular growth and its harmful ramifications. Medical Hypotheses. 2002, 58 (2): 93-112. 10.1054/mehy.2001.1463.CrossRefPubMed
38.
go back to reference Peck MN, Lundberg O: Short stature as an effect of economic and social conditions in childhood. Soc Sci Med. 1995, 41 (5): 733-738. 10.1016/0277-9536(94)00379-8.CrossRefPubMed Peck MN, Lundberg O: Short stature as an effect of economic and social conditions in childhood. Soc Sci Med. 1995, 41 (5): 733-738. 10.1016/0277-9536(94)00379-8.CrossRefPubMed
39.
go back to reference Goldbourt U, Tanne D: Body height is associated with decreased long-term stroke but not coronary heart disease mortality?. Stroke. 2002, 33 (3): 743-748. 10.1161/hs0302.103814.CrossRefPubMed Goldbourt U, Tanne D: Body height is associated with decreased long-term stroke but not coronary heart disease mortality?. Stroke. 2002, 33 (3): 743-748. 10.1161/hs0302.103814.CrossRefPubMed
40.
go back to reference Forsen T, Eriksson J, Qiao Q, Tervahauta M, Nissinen A, Tuomilehto J: Short stature and coronary heart disease: a 35-year follow-up of the Finnish cohorts of The Seven Countries Study. J Intern Med. 2000, 248 (4): 326-332. 10.1046/j.1365-2796.2000.00747.x.CrossRefPubMed Forsen T, Eriksson J, Qiao Q, Tervahauta M, Nissinen A, Tuomilehto J: Short stature and coronary heart disease: a 35-year follow-up of the Finnish cohorts of The Seven Countries Study. J Intern Med. 2000, 248 (4): 326-332. 10.1046/j.1365-2796.2000.00747.x.CrossRefPubMed
41.
go back to reference Velasquez-Melendez G, Martins IS, Cervato AM, Fornes NS, Marucci MF, Coelho LT: Relationship between stature, overweight and central obesity in the adult population in Sao Paulo, Brazil. Int J Obes Relat Metab Disord. 1999, 23 (6): 639-644. 10.1038/sj.ijo.0800895.CrossRefPubMed Velasquez-Melendez G, Martins IS, Cervato AM, Fornes NS, Marucci MF, Coelho LT: Relationship between stature, overweight and central obesity in the adult population in Sao Paulo, Brazil. Int J Obes Relat Metab Disord. 1999, 23 (6): 639-644. 10.1038/sj.ijo.0800895.CrossRefPubMed
42.
go back to reference Samaras TT, Elrick H, Storms LH: Is short height really a risk factor for coronary heart disease and stroke mortality? A review. Med Sci Monit. 2004, 10 (4): RA63-76.PubMed Samaras TT, Elrick H, Storms LH: Is short height really a risk factor for coronary heart disease and stroke mortality? A review. Med Sci Monit. 2004, 10 (4): RA63-76.PubMed
43.
go back to reference Remsberg KE, Demerath EW, Schubert CM, Chumlea WC, Sun SS, Siervogel RM: Early menarche and the development of cardiovascular disease risk factors in adolescent girls: the Fels Longitudinal Study. J Clin Endocrinol Metab. 2005, 90 (5): 2718-2724. 10.1210/jc.2004-1991.CrossRefPubMed Remsberg KE, Demerath EW, Schubert CM, Chumlea WC, Sun SS, Siervogel RM: Early menarche and the development of cardiovascular disease risk factors in adolescent girls: the Fels Longitudinal Study. J Clin Endocrinol Metab. 2005, 90 (5): 2718-2724. 10.1210/jc.2004-1991.CrossRefPubMed
44.
go back to reference Dunger DB, Lynn Ahmed M, Ong KK: Effects of obesity on growth and puberty. Best Pract Res Clin Endocrinol Metab. 2005, 19 (3): 375-390. 10.1016/j.beem.2005.04.005.CrossRefPubMed Dunger DB, Lynn Ahmed M, Ong KK: Effects of obesity on growth and puberty. Best Pract Res Clin Endocrinol Metab. 2005, 19 (3): 375-390. 10.1016/j.beem.2005.04.005.CrossRefPubMed
45.
go back to reference Ersoy B, Balkan C, Gunay T, Onag A, Egemen A: Effects of different socioeconomic conditions on menarche in Turkish female students. Early Hum Dev. 2004, 76 (2): 115-125. 10.1016/j.earlhumdev.2003.11.001.CrossRefPubMed Ersoy B, Balkan C, Gunay T, Onag A, Egemen A: Effects of different socioeconomic conditions on menarche in Turkish female students. Early Hum Dev. 2004, 76 (2): 115-125. 10.1016/j.earlhumdev.2003.11.001.CrossRefPubMed
46.
go back to reference Wattigney WA, Srinivasan SR, Chen W, Greenlund KJ, Berenson GS: Secular trends of earlier onset of menarche with increasing obesity in black and white girls: The Bogalusa Heart Study. Ethn Dis. 1999, 9: 181-189.PubMed Wattigney WA, Srinivasan SR, Chen W, Greenlund KJ, Berenson GS: Secular trends of earlier onset of menarche with increasing obesity in black and white girls: The Bogalusa Heart Study. Ethn Dis. 1999, 9: 181-189.PubMed
47.
go back to reference Pankow JS, Jacobs DR, Steinberger J, Moran A, Sinaiko AR: Insulin resistance and cardiovascular disease risk factors in children of parents with the insulin resistance (metabolic) syndrome. Diabetes Care. 2004, 27 (3): 775-780. 10.2337/diacare.27.3.775.CrossRefPubMed Pankow JS, Jacobs DR, Steinberger J, Moran A, Sinaiko AR: Insulin resistance and cardiovascular disease risk factors in children of parents with the insulin resistance (metabolic) syndrome. Diabetes Care. 2004, 27 (3): 775-780. 10.2337/diacare.27.3.775.CrossRefPubMed
48.
go back to reference Tanchoco C, Cruz AJ, Duante CA, Litonjua AD: Prevalence of metabolic syndrome among Filipino adults aged 20 years and over. Asia Pacific J Clin Nutr. 2003, 12 (3): 271-276. Tanchoco C, Cruz AJ, Duante CA, Litonjua AD: Prevalence of metabolic syndrome among Filipino adults aged 20 years and over. Asia Pacific J Clin Nutr. 2003, 12 (3): 271-276.
Metadata
Title
Gender, socio-economic status and metabolic syndrome in middle-aged and old adults
Publication date
01-12-2008
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-62

Other articles of this Issue 1/2008

BMC Public Health 1/2008 Go to the issue