Association between socioeconomic level and cardiovascular risk in the Peruvian population

ABSTRACT OBJECTIVE To determine the association between socioeconomic level and the presence of obesity, hypertension and type 2 diabetes mellitus in the Peruvian population. METHODS Secondary analysis of data from the National Demographic and Family Health Survey ( Encuesta Nacional Demográfica y de Salud Familiar , Endes) from 2018 to 2020. The outcomes were obesity, hypertension, and type 2 diabetes mellitus. The exposure variables were two indicators of socioeconomic status: educational level (< 7 years, 7–11 years, and 12+ years) and wealth index (in tertiles). Models were created using Poisson regression, reporting prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS Data from 98,846 subjects were analyzed. Mean age: 45.3 (SD: 16.0) years, and 55.5% were women. The prevalence of obesity was 26.0% (95%CI: 25.4–26.6); of hypertension, 24.9% (95%CI: 24.3–25.5); and of type 2 diabetes mellitus, 4.8% (95%CI: 4.5–5.1). In multivariate model, and compared with those with a low wealth index, those with a high wealth index had a higher prevalence of obesity (PR = 1.49; 95%CI: 1.38–1.62), hypertension (PR = 1.09; 95%CI: 1.02–1.17) and type 2 diabetes mellitus (PR = 1.72; 95%CI: 1.29–2.29). On the other hand, higher educational level was only associated with a reduction in the prevalence of obesity (PR = 0.89; 95%CI: 0.84–0.95). CONCLUSIONS There is a differential association between the wealth index, educational level and markers of noncommunicable diseases. There is evidence of a positive association between wealth index and obesity, hypertension and type 2 diabetes mellitus, whereas educational level was only negatively associated with obesity.

【摘要】
目的：明确秘鲁人群社会经济水平与肥胖、高血压及2型糖尿病（type 2 diabetes mellitus）患病情况的关联。
方法：对2018-2020年全国人口与家庭健康调查（Encuesta Nacional Demográfica y de Salud Familiar，ENDES）的数据开展二次分析。本研究的结局指标为肥胖、高血压及2型糖尿病，暴露变量为两项社会经济地位指标：受教育程度（分为<7年、7~11年、12年及以上三组）与财富指数（按三分位分组）。采用泊松回归（Poisson regression）构建统计模型，报告患病率比（prevalence ratios, PR）及95%置信区间（95% confidence intervals, 95%CI）。
结果：共纳入98846名研究对象进行数据分析，研究对象平均年龄为45.3岁（标准差（standard deviation, SD）：16.0），其中女性占比55.5%。肥胖患病率为26.0%（95%CI：25.4~26.6），高血压患病率为24.9%（95%CI：24.3~25.5），2型糖尿病患病率为4.8%（95%CI：4.5~5.1）。多因素模型分析结果显示，与低财富指数组相比，高财富指数组人群的肥胖（PR=1.49；95%CI：1.38~1.62）、高血压（PR=1.09；95%CI：1.02~1.17）及2型糖尿病（PR=1.72；95%CI：1.29~2.29）患病率均显著升高。此外，较高的受教育程度仅与肥胖患病率降低存在关联（PR=0.89；95%CI：0.84~0.95）。
结论：财富指数、受教育程度与非传染性疾病标志物之间存在差异化关联。本研究证实，财富指数与肥胖、高血压及2型糖尿病呈正相关，而受教育程度仅与肥胖呈负相关。