TY - JOUR

T1 - Socioeconomic disparity in cardiovascular disease

T2 - Possible biological pathways based on a proteomic approach

AU - Shafi, Bilal Hasan

AU - Bøttcher, Morten

AU - Ejupi, Ali

AU - Jensen, Gorm

AU - Osler, Merete

AU - Lange, Theis

AU - Prescott, Eva

N1 - Publisher Copyright: © 2022 The Authors

PY - 2022

Y1 - 2022

N2 - Background and aims: Large social disparities in the occurrence of cardiovascular disease (CVD) have been documented but the underlying biological mechanisms are largely unknown. We investigated a panel of biomarkers linked to CVD to improve our understanding and quantify the biological pathways in socioeconomic disparity in CVD and their mediation through behavioural and biological risk factors. Methods: We included 1142 participants from the Copenhagen City Heart Study aged 55–64 years. Socioeconomic position (SEP) was defined by the length of education and household income. Blood samples were analysed for 184 biomarkers (Olink). Pearson's correlation analysis and linear regression with multivariate adjustment for CVD risk factors were performed. Results: The median length of education was 10 (IQR 7–11) years and associated with age, sex, BMI, smoking, blood pressure, physical activity and income. 48 biomarkers were significantly correlated (p < 0.05) to the length of education. The strongest negative associations were seen for interleukin-6 (IL-6), metalloproteinase 12, growth/differentiation factor 15 (GDF-15), retinoic acid receptor responder protein 2 (RARRES2), leptin (LEP), von Willebrand factor (vWF), and renin (REN) (all p < 0.0001) while the strongest positive associations were seen for chymotrypsin, paraoxonase, epidermal growth factor receptor (EGFR) and brother of CDO (cell adhesion and platelet activation) (all p < 0.001). Proportion mediated by CVD risk factors ranged from <1% to 100%. After multivariate adjustment, 14 biomarkers remained significantly associated with education. Conclusions: SEP was associated with multiple biomarkers, indicating pathways involving inflammation (IL-6, RARRES2), platelet-activation (vWF, IL-6), blood pressure (REN, LEP) and Mitogen-activated protein kinase cascade (GDF-15, EGFR) may contribute to the socioeconomic differences in CVD.

AB - Background and aims: Large social disparities in the occurrence of cardiovascular disease (CVD) have been documented but the underlying biological mechanisms are largely unknown. We investigated a panel of biomarkers linked to CVD to improve our understanding and quantify the biological pathways in socioeconomic disparity in CVD and their mediation through behavioural and biological risk factors. Methods: We included 1142 participants from the Copenhagen City Heart Study aged 55–64 years. Socioeconomic position (SEP) was defined by the length of education and household income. Blood samples were analysed for 184 biomarkers (Olink). Pearson's correlation analysis and linear regression with multivariate adjustment for CVD risk factors were performed. Results: The median length of education was 10 (IQR 7–11) years and associated with age, sex, BMI, smoking, blood pressure, physical activity and income. 48 biomarkers were significantly correlated (p < 0.05) to the length of education. The strongest negative associations were seen for interleukin-6 (IL-6), metalloproteinase 12, growth/differentiation factor 15 (GDF-15), retinoic acid receptor responder protein 2 (RARRES2), leptin (LEP), von Willebrand factor (vWF), and renin (REN) (all p < 0.0001) while the strongest positive associations were seen for chymotrypsin, paraoxonase, epidermal growth factor receptor (EGFR) and brother of CDO (cell adhesion and platelet activation) (all p < 0.001). Proportion mediated by CVD risk factors ranged from <1% to 100%. After multivariate adjustment, 14 biomarkers remained significantly associated with education. Conclusions: SEP was associated with multiple biomarkers, indicating pathways involving inflammation (IL-6, RARRES2), platelet-activation (vWF, IL-6), blood pressure (REN, LEP) and Mitogen-activated protein kinase cascade (GDF-15, EGFR) may contribute to the socioeconomic differences in CVD.

KW - Biological pathways

KW - Biomarkers

KW - Cardiovascular disease

KW - Mediation analysis

KW - Proteomics

KW - Socioeconomic position

U2 - 10.1016/j.atherosclerosis.2022.05.020

DO - 10.1016/j.atherosclerosis.2022.05.020

M3 - Journal article

C2 - 35691266

AN - SCOPUS:85131536135

VL - 352

SP - 62

EP - 68

JO - Journal of atherosclerosis research

JF - Journal of atherosclerosis research

SN - 1567-5688

ER -