Diabetes Care
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Diabetes Care 29:2694-2700, 2006
DOI: 10.2337/dc06-0022
© 2006 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Article

Household Wealth and the Metabolic Syndrome in the Whitehall II Study

Pablo Perel, MD1,2, Claudia Langenberg, MD1, Jane Ferrie, PHD1, Kath Moser, BA2, Eric Brunner, PHD1 and Michael Marmot, FRCP1

1 International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, London, U.K
2 Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K.

Address correspondence and reprint requests to Claudia Langenberg, MD, International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, U.K. E-mail: c.langenberg{at}ucl.ac.uk

OBJECTIVE—The metabolic syndrome is more common in socially disadvantaged groups. Inequalities in household wealth are currently widening and may contribute to the increasing prevalence of the metabolic syndrome.

RESEARCH DESIGN AND METHODS—This was a cross-sectional analysis of 1,509 women and 4,090 men (aged 45.2–68.9 years) of an occupational cohort study of 20 civil service departments located in London, U.K. Components of the metabolic syndrome were measured in 1997–1999 and defined using a modified World Health Organization definition.

RESULTS—Own income, household income, and wealth were each strongly and inversely associated with the metabolic syndrome in both sexes (Ptrend < 0.001). Within each group of household wealth, the prevalence of the metabolic syndrome was higher in men than in women. Sex differences became smaller with decreasing household wealth, with the prevalence of the metabolic syndrome rising from 12.0 and 5.7% in the wealthiest men and women, respectively, to corresponding values of 23.6 and 20.1% in the poorest group. The odds ratio (95% CI) associated with each decrease of one category in household wealth was 1.25 (1.03–1.50) in men and 1.69 (1.18–2.41) in women, adjusting for age, household members, occupational grade, education, father’s social class, personal and household income, ethnic group, smoking, alcohol intake, diet, and physical activity.

CONCLUSIONS— Household wealth, a measure of assets accumulated over decades and generations, is strongly and inversely associated with the metabolic syndrome. Future research should explore the potential mechanisms by which wealth inequalities are associated with the metabolic syndrome.

Abbreviations: HOMA, homeostasis model assessment • WHO, World Health Organization


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