| Title: | Education, biological ageing, all-cause and cause-specific mortality and morbidity: UK biobank cohort study |
| Journal: | EClinicalMedicine |
| Published: | 19 Nov 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/33437953/ |
| DOI: | https://doi.org/10.1016/j.eclinm.2020.100658 |
| URL: | http://www.thelancet.com/article/S2589537020304028/pdf |
Publication 4745
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Abstract
BACKGROUND: Socioeconomic position as measured by education may be embodied and affect the functioning of key physiological systems. Links between social disadvantage, its biological imprint, and cause-specific mortality and morbidity have not been investigated in large populations, and yet may point towards areas for public health interventions beyond targeting individual behaviours.</p>
METHODS: Using data from 366,748 UK Biobank participants with 13 biomarker measurements, we calculated a Biological Health Score (BHS, ranging from 0 to 1) capturing the level of functioning of five physiological systems. Associations between BHS and incidence of cardiovascular disease (CVD) and cancer, and mortality from all, CVD, cancer, and external causes were examined. We explored the role of education in these associations. Mendelian randomisation using genetic evidence was used to triangulate these findings.</p>
FINDINGS: An increase in BHS of 0.1 was associated with all-cause (HR = 1.14 [1.12-1.16] and 1.09 [1.07-1.12] in men and women respectively), cancer (HR = 1.11 [1.09-1.14] and 1.07 [1.04-1.10]) and CVD (HR = 1.25 [1.20-1.31] and 1.21 [1.11-1.31]) mortality, CVD incidence (HR = 1.15 [1.13-1.16] and 1.17 [1.15-1.19]). These associations survived adjustment for education, lifestyle-behaviours, body mass index (BMI), co-morbidities and medical treatments. Mendelian randomisation further supported the link between the BHS and CVD incidence (HR = 1.31 [1.21-1.42]). The BHS contributed to CVD incidence prediction (age-adjusted C-statistic = 0.58), other than through education and health behaviours.</p>
INTERPRETATION: The BHS captures features of the embodiment of education, health behaviours, and more proximal unknown factors which all complementarily contribute to all-cause, cancer and CVD morbidity and premature death.</p>
17 Authors
- Marc Chadeau-Hyam
- Barbara Bodinier
- Roel Vermeulen
- Maryam Karimi
- Verena Zuber
- Raphaële Castagné
- Joshua Elliott
- David Muller
- Dusan Petrovic
- Matthew Whitaker
- Silvia Stringhini
- Ioanna Tzoulaki
- Mika Kivimäki
- Paolo Vineis
- Paul Elliott
- Michelle Kelly-Irving
- Cyrille Delpierre
1 Application
| Application ID | Title |
|---|---|
| 13436 | Genetic determinants and biological pathways linking major inflammatory biomarkers to disease outcomes |
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