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Socioeconomic status and cardio-metabolic disease: an epidemiological perspective on the biology of social adversity

Applicant Stringhini Silvia
Number 147998
Funding scheme Ambizione
Research institution Institut Universitaire de Médecine Sociale et Préventive - IUMSP CHUV et Université de Lausanne
Institution of higher education University of Lausanne - LA
Main discipline Cardiovascular Diseases
Start/End 01.09.2013 - 31.08.2016
Approved amount 577'748.00
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All Disciplines (6)

Discipline
Cardiovascular Diseases
Public Health and Health Services
Sociology
Molecular Biology
Economics
Metabolic Disorders

Keywords (7)

cardio-metabolic disorders; biological mechanisms; lifestyle factors; lifecourse; socioeconomic status; epigenetics; cohort studies

Lay Summary (Italian)

Lead
Numerosi studi mostrano che le malattie cardio-metaboliche sono molto più frequenti nelle fasce più svantaggiate della popolazione. Questo progetto utilizzerà dati provenienti da vari paesi per analizzare i meccanismi biologici (ad esempio epigenetici, infiammatori, etc) che spiegano il legame tra avversità sociale nel corso della vita e insorgenza delle malattie cardio-metaboliche all’età adulta.
Lay summary

Soggetto e obiettivo

Le disuguaglianze sociali in salute sono un fenomeno onnipresente. Tuttavia, la ricerca deve ancora fornire una comprensione completa dei meccanismi sottostanti. Studi recenti hanno suggerito che le differenze negli stili di vita possono contribuire a spiegare una grande percentuale delle disuguaglianze sociali in salute. Negli ultimi anni, la ricerca ha iniziato ad affrontare la questione di come lo stato socio-economico sia concretamente incorporato in termini biologici. Questo progetto di ricerca si concentrerà sulle malattie cardio-metaboliche, che mostrano un forte gradiente sociale e il cui onere nelle fasce più svantaggiate della società è in rapido aumento in tutto il mondo. L'obiettivo generale è quello di estendere lo studio delle disuguaglianze sociali in salute e dei loro determinanti, integrando l'analisi dei meccanismi biologici che collegano l’avversità sociale durante tutta la vita e le malattie cardio-metaboliche.

Contesto socio-scientifico

La multidisciplinarietà (epidemiologia sociale, cardiovascolare, cardio-metabolica e genetica, salute pubblica, medicina del sonno, medicina interna, e biologia molecolare) che caratterizza questo progetto di ricerca offre un potenziale per produrre risposte nuove e innovative alla questione di come lo stato socioeconomico nel corso della vita possa influenzare la salute fino a decenni più tardi. Inoltre, l'uso di cinque basi di dati provenienti da diversi paesi e che offrono un vasto numero di fenotipi misurati ripetutamente nel tempo, insieme ad indicatori precisi dello stato socioeconomico consentirà la replica dei risultati e l'esame delle variazioni potenziali tra paesi.

Direct link to Lay Summary Last update: 02.09.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
A life course approach to explore the biological embedding of socioeconomic position and social mobility through circulating inflammatory markers
Castagne Raphaele, Delpierre Cyrille, Kelly-Irving Michelle, Campanella Gianluca, Guida Florence, Krogh Vittorio, Palli Domenico, Panico Salvatore, Sacerdote Carlotta, Tumino Rosario, Kyrtopoulos Soterios, Hosnijeh Fatemeh Saberi, Lang Thierry, Vermeulen Roel, Vineis Paolo, Stringhini Silvia, Chadeau-Hyam Marc (2016), A life course approach to explore the biological embedding of socioeconomic position and social mobility through circulating inflammatory markers, in SCIENTIFIC REPORTS, 6, 25170.
Barriers to healthy eating in Switzerland: A nationwide study.
de Mestral Carlos, Stringhini Silvia, Marques-Vidal Pedro (2016), Barriers to healthy eating in Switzerland: A nationwide study., in Clinical nutrition (Edinburgh, Scotland), 324.
Educational differences in dietary intake and compliance with dietary recommendations in a Swiss adult population.
Mayén Ana Chacon, Guessous Idris, Paccaud Fred, Stringhini Silvia, Marques-VIdal Pedro (2016), Educational differences in dietary intake and compliance with dietary recommendations in a Swiss adult population., in International Journal of Public Health, 23.
Educational differences in dietary intake and compliance with dietary recommendations in a Swiss adult population.
Mayén Ana-Lucia, Guessous Idris, Paccaud Fred, Stringhini Silvia, Marques-Vidal Pedro (2016), Educational differences in dietary intake and compliance with dietary recommendations in a Swiss adult population., in International journal of public health, 414.
Ideal Body Size as a Mediator for the Gender-Specific Association Between Socioeconomic Status and Body Mass Index: Evidence From an Upper-Middle-Income Country in the African Region.
Yepes Maryam, Maurer Jürgen, Stringhini Silvia, Viswanathan Barathi, Gedeon Jude, Bovet Pascal (2016), Ideal Body Size as a Mediator for the Gender-Specific Association Between Socioeconomic Status and Body Mass Index: Evidence From an Upper-Middle-Income Country in the African Region., in Health education & behavior : the official publication of the Society for Public Health Education, 43(1 Suppl), 56-63.
Lifecourse socioeconomic status and type 2 diabetes: the role of chronic inflammation in the English Longitudinal Study of Ageing.
Stringhini Silvia, Zaninotto Paola, Kumari Meena, Kivimaki Mika, Batty G David (2016), Lifecourse socioeconomic status and type 2 diabetes: the role of chronic inflammation in the English Longitudinal Study of Ageing., in Scientific Reports, 214.
Persistent spatial clusters of high body mass index in a Swiss urban population as revealed by the 5-year GeoCoLaus longitudinal study.
Joost Stéphane, Duruz Solange, Marques-Vidal Pedro, Bochud Murielle, Stringhini Silvia, Paccaud Fred, Gaspoz Jean-Michel, Theler Jean-Marc, Chételat Joël, Waeber Gérard, Vollenweider Peter, Guessous Idris (2016), Persistent spatial clusters of high body mass index in a Swiss urban population as revealed by the 5-year GeoCoLaus longitudinal study., in BMJ open, 6(1), 010145-010145.
Sociodemographic, behavioral and genetic determinants of allostatic load in a Swiss population-based study.
Petrovic Dusan, Pivin Edward, Ponte Belen, Dhayat Nasser, Pruijm Menno, Ehret Georg, Ackermann Daniel, Guessous Idris, Younes Sandrine Estoppey, Pechère-Bertschi Antoinette, Vogt Bruno, Mohaupt Markus, Martin Pierre-Yves, Paccaud Fred, Burnier Michel, Bochud Murielle, Stringhini Silvia (2016), Sociodemographic, behavioral and genetic determinants of allostatic load in a Swiss population-based study., in Psychoneuroendocrinology, 67, 76-85.
Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles.
Mayén Ana-Lucia, Bovet Pascal, Marti-Soler Helena, Viswanathan Bharathi, Gedeon Jude, Paccaud Fred, Marques-Vidal Pedro, Stringhini Silvia (2016), Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles., in PloS one, 11(5), 0155617-0155617.
Socioeconomic predictors of dietary patterns among Guatemalan adults.
Mayén Ana-Lucia, Stringhini Silvia, Ford Nicole D, Martorell Reynaldo, Stein Aryeh D, Paccaud Fred, Marques-Vidal Pedro (2016), Socioeconomic predictors of dietary patterns among Guatemalan adults., in International journal of public health, 1.
The biological embedding of social differences in ageing trajectories.
Vineis Paolo, Kelly-Irving Michelle, Rappaport Stephen, Stringhini Silvia (2016), The biological embedding of social differences in ageing trajectories., in Journal of epidemiology and community health, 70(2), 111-3.
The social patterning of risk factors for noncommunicable diseases in five countries: evidence from the modeling the epidemiologic transition study (METS).
Stringhini Silvia, Forrester Terrence E, Plange-Rhule Jacob, Lambert Estelle V, Viswanathan Bharathi, Riesen Walter, Korte Wolfgang, Levitt Naomi, Tong Liping, Dugas Lara R, Shoham David, Durazo-Arvizu Ramon A, Luke Amy, Bovet Pascal (2016), The social patterning of risk factors for noncommunicable diseases in five countries: evidence from the modeling the epidemiologic transition study (METS)., in BMC public health, 16, 956-956.
Association between education and quality of diabetes care in Switzerland.
Flatz Aline, Casillas Alejandra, Stringhini Silvia, Zuercher Emilie, Burnand Bernard, Peytremann-Bridevaux Isabelle (2015), Association between education and quality of diabetes care in Switzerland., in International journal of general medicine, 8, 87-92.
Association of socioeconomic status with inflammatory markers: A two cohort comparison
Fraga Silvia, Marques-Vidal Pedro, Vollenweider Peter, Waeber Gerard, Guessous Idris, Paccaud Fred, Barros Henrique, Stringhini Silvia (2015), Association of socioeconomic status with inflammatory markers: A two cohort comparison, in PREVENTIVE MEDICINE, 71, 12-19.
Association of socioeconomic status with sleep disturbances in the Swiss population-based CoLaus study.
Stringhini Silvia, Haba-Rubio José, Marques-Vidal Pedro, Waeber Gérard, Preisig Martin, Guessous Idris, Bovet Pascal, Vollenweider Peter, Tafti Mehdi, Heinzer Raphael (2015), Association of socioeconomic status with sleep disturbances in the Swiss population-based CoLaus study., in Sleep medicine, 16(4), 469-76.
Biological embedding of early-life exposures and disease risk in humans: a role for DNA methylation.
Demetriou Christiana A, van Veldhoven Karin, Relton Caroline, Stringhini Silvia, Kyriacou Kyriacos, Vineis Paolo (2015), Biological embedding of early-life exposures and disease risk in humans: a role for DNA methylation., in European journal of clinical investigation, 45(3), 303-32.
Sociodemographic and Behavioural Determinants of a Healthy Diet in Switzerland
Marques-Vidal Pedro, Waeber Gerard, Vollenweider Peter, Bochud Murielle, Stringhini Silvia, Guessous Idris (2015), Sociodemographic and Behavioural Determinants of a Healthy Diet in Switzerland, in ANNALS OF NUTRITION AND METABOLISM, 67(2), 87-95.
Socio-demographic and behavioural determinants of weight gain in the Swiss population
Guerra Filipa, Stringhini Silvia, Vollenweider Peter, Waeber Gerard, Marques-Vidal Pedro (2015), Socio-demographic and behavioural determinants of weight gain in the Swiss population, in BMC PUBLIC HEALTH, 15, 1.
Socio-demographic and behavioural determinants of weight gain in the Swiss population.
Guerra Filipa, Stringhini Silvia, Vollenweider Peter, Waeber Gérard, Marques-Vidal Pedro (2015), Socio-demographic and behavioural determinants of weight gain in the Swiss population., in BMC public health, 15, 73-73.
Association of education and receiving social transfers with allostatic load in the Swiss population-based CoLaus study.
Nicod Edouard, Stringhini Silvia, Marques-Vidal Pedro, Paccaud Fred, Waeber Gérard, Lamiraud Karine, Vollenweider Peter, Bochud Murielle (2014), Association of education and receiving social transfers with allostatic load in the Swiss population-based CoLaus study., in Preventive medicine, 63, 63-71.
Association of socioeconomic status with overall and cause specific mortality in the republic of seychelles: results from a cohort study in the african region.
Stringhini Silvia, Rousson Valentin, Viswanathan Bharathi, Gedeon Jude, Paccaud Fred, Bovet Pascal (2014), Association of socioeconomic status with overall and cause specific mortality in the republic of seychelles: results from a cohort study in the african region., in PloS one, 9(7), 102858-102858.
Forgoing dental care for economic reasons in Switzerland: a six-year cross-sectional population-based study.
Guessous Idris, Theler Jean-Marc, Izart Claire Durosier, Stringhini Silvia, Bodenmann Patrick, Gaspoz Jean-Michel, Wolff Hans (2014), Forgoing dental care for economic reasons in Switzerland: a six-year cross-sectional population-based study., in BMC oral health, 14, 121-121.
Seasonal variation of overall and cardiovascular mortality: a study in 19 countries from different geographic locations.
Marti-Soler Helena, Gonseth Semira, Gubelmann Cédric, Stringhini Silvia, Bovet Pascal, Chen Pau-Chung, Wojtyniak Bogdan, Paccaud Fred, Tsai Dai-Hua, Zdrojewski Tomasz, Marques-Vidal Pedro (2014), Seasonal variation of overall and cardiovascular mortality: a study in 19 countries from different geographic locations., in PloS one, 9(11), 113500-113500.
Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review.
Mayén Ana-Lucia, Marques-Vidal Pedro, Paccaud Fred, Bovet Pascal, Stringhini Silvia (2014), Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review., in The American journal of clinical nutrition, 100(6), 1520-31.
The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization.
Vineis Paolo, Stringhini Silvia, Porta Miquel (2014), The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization., in Environmental research, 133, 424-30.
[Social medicine: does it still make sense in 2013?].
Vu Francis, Bischoff Thomas, Wolff Hans, Guessous Idris, Dory Elodie, Dubois-Arber Françoise, Stringhini Silvia, Bodenmann Patrick (2013), [Social medicine: does it still make sense in 2013?]., in Revue médicale suisse, 9(408), 1-7.
Decreasing educational differences in mortality over 40 years: evidence from the Turin Longitudinal Study (Italy).
Stringhini Silvia, Spadea Teresa, Stroscia Morena, Onorati Roberta, Demaria Moreno, Zengarini Nicolás, Costa Giuseppe, Decreasing educational differences in mortality over 40 years: evidence from the Turin Longitudinal Study (Italy)., in Journal of epidemiology and community health, Epub ahead of print.
Life-course socioeconomic status and DNA methylation of genes regulating inflammation.
Stringhini Silvia, Polidoro Silvia, Sacerdote Carlotta, Kelly Rachel S, van Veldhoven Karin, Agnoli Claudia, Grioni Sara, Tumino Rosario, Giurdanella Maria Concetta, Panico Salvatore, Mattiello Amalia, Palli Domenico, Masala Giovanna, Gallo Valentina, Castagné Raphaële, Paccaud Fred, Campanella Gianluca, Chadeau-Hyam Marc, Vineis Paolo, Life-course socioeconomic status and DNA methylation of genes regulating inflammation., in International journal of epidemiology, Epub ahead of print.

Collaboration

Group / person Country
Types of collaboration
Loyola University, Department of Preventive Medicine and Epidemiology United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Institute of Social and Preventive Medicine, University of Lausanne Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
University of Turin, Servizio Sovranazionale di Epidemiologia Italy (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Imperial College London, Centre for Environment and Health School of Public Health Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Lausanne University Hospital, Centre for Psychiatric Epidemiology Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Lausanne University Hospital, Centre for Investigation and Research in Sleep Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Lausanne University Hospital, Department of Internal Medicine Switzerland (Europe)
- Publication
- Research Infrastructure
Institute of Public Health, University of Porto Portugal (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
University College London, Department of Epidemiology and Public Health Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
EPIGENomics and Health Care Policy: Challenges and Opportunities Individual talk The biological consequences of social inequalities 01.12.2014 Milan, Italy Stringhini Silvia;
Swiss Public Health Conference Talk given at a conference Association of Socioeconomic Status with Allostatic Load in the Swiss Population-based CoLaus Study 19.11.2014 Glasgow, United States of America Stringhini Silvia;
European Public Health Conference Talk given at a conference Life-course socioeconomic status and DNA methylation of genes regulating inflammation 19.11.2014 Glasgow, Great Britain and Northern Ireland Stringhini Silvia;
European Public Health Conference Poster Decreasing educational differences in mortality over 40-years: evidence from the Turin Longitudinal Study (Italy) 19.11.2014 Glasgow, Great Britain and Northern Ireland Stringhini Silvia;
European Public Health Conference Poster Association of socioeconomic status with sleep disturbances in the Swiss population-based CoLaus study 19.11.2014 Glasgow, Great Britain and Northern Ireland Stringhini Silvia;
Workshop on panel data, University of Lausanne Individual talk Socioeconomic Status in Health Research: The Inclusion of Social Sciences Questionnaires in Health Sciences Panel 26.06.2014 Lausanne, Switzerland Stringhini Silvia;


Knowledge transfer events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Convention CHAM, Chamonix Talk 27.09.2014 Chamonix, France


Communication with the public

Communication Title Media Place Year
Talks/events/exhibitions Convention CHAM International 2014

Awards

Title Year
"Premio Maccacaro", prize awarded by the Italian Association of Epidemiology for the best work from a young epidemiologist. Awarded in Rome during the annual meeting of the association. 2013

Associated projects

Number Title Start Funding scheme
167732 Socioeconomic status and cardio-metabolic disease: an epidemiological perspective on the biology of social adversity 01.09.2016 Ambizione

Abstract

Social inequalities in health are a ubiquitous phenomenon. Conversely, research still has to provide a comprehensive understanding of the mechanisms underlying them. Several processes of social causation have been postulated, including patterns of unhealthy behaviors, psychosocial factors, and living and working conditions. Recent studies suggested that differences in lifestyle may contribute to a large proportion of social inequalities in health. In the last years, research started addressing the issue of how socioeconomic status eventually “gets under the skin”. Human and animal studies have identified several interrelated processes through which the social environment could be embedded, including dysregulation of the hypothalamic-pituitary-adrenal axis, inflammatory processes, neural function and structure, and, ultimately, epigenetic mechanisms. These studies cover a promising new field of research, and several questions remain to be addressed: 1.Studies examining the biology of social adversity have generally described socioeconomic differences in biological markers, but the actual contribution of these intermediate steps to social inequalities in chronic diseases has rarely been evaluated. Further, few studies have evaluated the interactions between lifestyle-related risk factors and biological markers. 2.Some new lifestyle factors potentially implicated in the etiology of socioeconomic differences in health, such as inadequate sleep, have been under-researched. 3.The influence of early life vs. adult socioeconomic status on the biological pathways leading to diseases remains unknown, as well as the extent to which the impact of early life exposure to social adversity can be modified later in life. This research project will focus on cardio-metabolic disorders, which show a strong gradient in their social distribution and whose burden on the most disadvantaged sections of society is rapidly increasing worldwide. The overarching aim is to extend the study of social inequalities in health and their determinants by incorporating an analysis of the biological mechanisms linking lifetime social adversity to cardio-metabolic disease. Specific aims of this research are: 1.To assess the contribution of lifestyle factors (unhealthy behaviors, chronic stress and inadequate sleep) to the association between lifecourse socioeconomic status and cardio-metabolic disorders. 2.To establish the extent to which the contribution of lifestyle factors to social inequalities in cardio-metabolic disorders is mediated by socioeconomic differences in inflammatory markers.3.To understand if social adversity in early life has an impact on gene expression and DNA methylation, and if this can partly explain socioeconomic differences in inflammatory markers. This research project will provide a better understanding of the social, behavioural and biological pathways leading from lifetime socioeconomic adversity to adult life cardio-metabolic disease risk. This will not only add further observations on the role of exposure in early life in shaping health through adulthood, but will also clarify to what extent exposure to early life social adversity has an impact on adult health through behavioural vs. biological pathways. Moreover, this research will establish the extent to which the undesirable health consequences of adverse social exposure in early life are potentially reversible. Last but not least, an epigenome-wide analysis of socioeconomic differences in gene regulation will allow new insight to be gained into the mechanisms through which the social environment has an impact on health. Analyses will be conducted using data from 3 Swiss population-based studies (the CoLaus study, N=6000; the Bus Santé study, N=15,000; the SKIPOGH study, N=1100), the British Whitehall II study (N=10,308), and the multi-country METS study (N=2500). All studies have a longitudinal design allowing the assessment of incident health outcomes. Several indicators of socioeconomic status across the lifecourse (educational level, income, father’s occupation, among others) will be used in this research project. Lifestyle factors considered are health behaviors (smoking, alcohol consumption, diet and physical activity), inadequate sleep and chronic stress. Information on epigenome-wide gene expression and DNA methylation will be collected in a subsample of 250 participants of the SKIPOGH study. The multidisciplinarity (social epidemiology, cardiovascular, cardio-metabolic and genetic epidemiology, public health, sleep medicine, internal medicine, and molecular biology) characterizing this research project offers potential to produce novel and innovative answers to the question of how socioeconomic status over the lifecourse leads to disease decades later. Further, the use of five datasets offering a vast number of phenotypes measured repeatedly over time, along with precise indicators of socioeconomic status over the lifecourse, will allow the replication of results to ensure their consistency and the examination of between-country variations.
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