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Sozioökonomischer Status und inflammatorische Biomarker für Herz-Kreislauf-Erkrankungen

Wie wirken Bildung, Beruf und Einkommen?

Socioeconomic status and inflammatory biomarkers of cardiovascular diseases

How do education, occupation and income operate?

Herz volume 40, pages 298–304 (2015)Cite this article

Zusammenfassung

Hintergrund

Inflammatorische Prozesse spielen eine bedeutende Rolle in der Entstehung von Herz-Kreislauf-Erkrankungen (HKE) und können durch anhaltenden Stress ausgelöst werden. Damit stellen sie einen möglichen psychobiologischen Pfad dar, über den alltägliche Erfahrungen sozialer Gruppen „unter die Haut gehen“. Die Untersuchung sozioökonomischer Unterschiede inflammatorischer Marker gilt als ein vielversprechender Ansatz, den sozialen Gradienten von HKE aufzuklären. Unter Berücksichtigung der unterschiedlichen Bedeutung der Sozialstatusindikatoren Bildung, Beruf und Einkommen ist es das Ziel des vorliegenden Beitrags, einen Überblick über sozioökonomische Unterschiede inflammatorischer Biomarker zu geben.

Ergebnisse

Es liegt eine hohe Evidenz für einen Zusammenhang zwischen dem sozioökonomischen Status und inflammatorischen Biomarkern vor. Eine differenzierte Betrachtung zeigt die Bedeutung aller einzelnen Sozialstatusindikatoren auf. Neben einem schlechteren Gesundheitsstatus und einem ungünstigeren Gesundheitsverhalten in niedrigeren Sozialschichten sind auch psychobiologische Prozesse infolge einer erhöhten Stressexposition für den Zusammenhang verantwortlich.

Schlussfolgerungen

Ein niedriger sozioökonomischer Status geht mit einer erhöhten Exposition gegenüber Stressoren einher, die biologische Reaktionen auslösen und zu einem erhöhten Risiko für HKE führen können. Das anamnestische Gespräch in der Kardiologie sollte auch auf eine mögliche sozialstrukturell bedingte spezifische Belastungskonstellation hin ausgerichtet werden und dabei auch die unterschiedliche Wirksamkeit der einzelnen sozialen Schichtindikatoren berücksichtigen.

Abstract

Background

In light of the consistent SES gradient in cardiovascular diseases, current research is focusing on possible pathways through which the socioeconomic status (SES) may impact health. Inflammatory processes play a critical role in the development of cardiovascular diseases and are associated with stress. Therefore, they might be one psychobiological pathway explaining how the SES gets under the skin. Considering the different meanings of education, occupation and income, this article gives an overview of the association between inflammatory biomarkers and socioeconomic status.

Results

There is high evidence for associations between indicators of SES – education, occupation and income – and inflammatory biomarkers. Possible pathways are health status, health behavior and psychobiological processes as a result of increased exposure to psychosocial stress.

Conclusions

The SES gradient in cardiovascular diseases reflects behavioral as well as physiological pathways and systemic inflammation seems to be involved. Low SES is associated with an increased exposure to adverse circumstances of life, which can trigger biological responses and result in an increased risk of cardiovascular diseases. Medical history taking in cardiology should focus on socio-structural exposures and thereby reflect the different meanings of education, occupation and income.

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Interessenkonflikt. F. Rosenbach, M. Richter und T.-K. Pförtner geben an, dass kein Interessenkonflikt besteht.

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  1. Institut für Medizinische Soziologie , Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland

    F. Rosenbach, M. Richter & T.-K. Pförtner

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Rosenbach, F., Richter, M. & Pförtner, TK. Sozioökonomischer Status und inflammatorische Biomarker für Herz-Kreislauf-Erkrankungen. Herz 40, 298–304 (2015). https://doi.org/10.1007/s00059-013-4040-7

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Schlüsselwörter

  • Sozioökonomischer Status
  • Kardiologie
  • Inflammation
  • Psychosoziale Belastungen
  • Psychobiologie

Keywords

  • Socioeconomic status
  • Cardiology
  • Inflammation
  • Psychosocial factors
  • Psychobiology