Abstract 4146: Socioeconomic Factors Predict the Development of the Metabolic Syndrome in Different Ethnic Groups in Mid-life Women: the Study of Women’s Health Across the Nation (SWAN)
Objective: To determine the respective roles of socioeconomic status (SES) and ethnicity on the risk of developing the metabolic syndrome in middle aged women
Subjects and Methods: We studied 2456 female participants (mean age 46 ± 3 yrs) in the Study of Women’s Health Across the Nation (SWAN) who did not have the metabolic syndrome and who were not using hormone therapy at baseline. Five-year incidence of the metabolic syndrome, defined according to the ATP III criteria, was the main outcome.
Results: A total of 242 women (9.9%) developed the metabolic syndrome during 5 years of follow-up . Significant univariate predictors of incident metabolic syndrome were: Ethnicity (compared to Caucasian women, Japanese: RR 0.63, 95% CI 0.40– 0.99; Chinese: RR 0.77, 95% CI 0.49–1.22; Hispanic: RR 4.04, 95% CI 2.55– 6.39; African American: RR 1.71, 95% CI 1.30–2.26); and SES (less than high school degree vs higher than Post college degree:RR 3.83, 95% CI 2.32– 6.33; annual income less than $20,000 vs annual income > $75,000 RR 3.16, 95% CI 2.16– 4.63). In multivariate models, adjusted for site, menopausal status, baseline age, baseline smoking status, and the baseline value of each of the component of the metabolic syndrome, only SES, specifically low education (RR 1.71, 95% CI 1.04–2.81, p< 0.01), remained a significant predictor of incident metabolic syndrome. No evidence of an interaction between SES and ethnicity was detected.
Conclusion: Greater socio-economic disadvantage is a significant, independent predictor of incident metabolic syndrome in women at mid-life. Acknowledgments: The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health, DHHS, through the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women’s Health (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495).