Role of Plasma Proteins in the Association Between Socioeconomic Status and Cardiovascular Disease Events: Results From Trans-Omics for Precision Medicine Cohorts.
LáShauntá M Glover, Madeline G Gillman, Michael D Green et al.
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In 30 seconds
This meta-analysis examined socioeconomic status (SES), plasma proteins, and incident coronary heart disease (CHD) and stroke in participants from three cohorts. SES was scored using education, income, and employment; associations with events and 1,270 proteins were assessed, followed by mediation analyses. Higher SES scores were associated with lower CHD risk (hazard ratio [HR], 0.74 [95% CI, 0.63-0.87]) and lower stroke risk (HR, 0.81 [95% CI, 0.66-1.00]). Of 233 proteins associated with SES after multiple-testing correction, 21 showed a significant indirect effect on the SES–CHD association.
Key findings
- Higher SES scores were associated with lower CHD risk (HR, 0.74 [95% CI, 0.63-0.87]).
- Higher SES scores were associated with lower stroke risk (HR, 0.81 [95% CI, 0.66-1.00]).
- After multiple-testing correction, 233 proteins were associated with SES; 21 had a significant indirect effect on the SES–CHD association.
- Proteins were not tested as mediators of stroke because the SES–stroke association was not statistically significant.
Why it matters
The findings connect a social determinant of health with measurable plasma-protein patterns and CHD events across multiple cohorts. The mediation results offer candidate biological pathways for further study, while underscoring that proteomic associations do not establish a causal mechanism. Considering social conditions alongside biological risk factors may help frame research into cardiovascular health disparities.
What to keep in mind
The cohort-based analyses and regression mediation approach identify associations and statistical indirect effects, not causal pathways. The SES–stroke association was not statistically significant, so mediation was not assessed for stroke.