Socioeconomic disparities in metabolic syndrome differ by gender: Evidence from NHANES III

PURPOSE: The aim of the study is to examine whether socioeconomic position (SEP) is associated with metabolic syndrome and whether the association differs by gender and race/ethnicity. METHODS: Study participants were from the Third National Health and Nutrition Examination Survey. SEP was measured by using education and poverty income ratio (PIR). Metabolic syndrome was measured according to the National Institutes of Health guidelines. Multivariable-adjusted logistic regression analyses were performed. RESULTS: Low education (< 12 years) was associated with metabolic syndrome in women (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.39-2.24) and less so in men (OR, 1.27; 95% CI, 0.97-1.66) versus more than 12 years of education. For income, low PIR (<= 1) was related to metabolic syndrome in women (OR, 1.81; 95% CI, 1.37-2.40) and not men (OR, 0.98; 95% CI, 0.74-1.29) versus PIR greater than 3. SEP was associated with metabolic syndrome in white, black, and Mexican-American women. Education was associated with all five metabolic syndrome components in women and only three components (abdominal obesity, hypertension, and hyperglycemia) in men. CONCLUSIONS: SEP is associated with metabolic syndrome in white, black, and Mexican-American women and is associated less strongly in men. The findings provide biologic mechanistic evidence of previously documented associations between SEP and such clinical disorders as type 2 diabetes and coronary heart disease. These results underscore the clinical significance of SEP, particularly for women.