sep obesity and cvd
DESCRIPTION
The effect of obesity, and SEP on riskfactors for CVDTRANSCRIPT
Critical appraisal of a cohort studyHowe et al. Int J Obes 2010;34:1149-1159.
Ulla SovioCORGI Journal Club
22 Sept 2010
Introduction
• Motivation – why this paper?1. Public health importance; deals with inequalities 2. Recent key paper in paediatric obesity research3. Deals with methodological challenges that need
to be addressed in our own work• missing data and selection bias: multiple imputation• confounding: adjustments• effect modification: interactions and stratified analysis• mediation of effects: path analysis
Introduction
• Motivation – why this paper?4. Based on the prospective ALSPAC cohort, which
will be used in our project – this paper might • give important insights into the data• help us work on our own study questions • generate new ideas
Introduction
• Study questions1. Are there socioeconomic inequalities in
cardiovascular risk factors in childhood?2. If yes, are they mediated by adiposity?
Introduction
• What is already known? What this study adds?
Low childhood SEP Higher risk of adult CVD and T2D
known association but mechanism unclear
Childhood adiposity
known association in high-income countries
Adult adiposity
known association: tracking of obesity over time
known association
Q1: Low childhood SEP => Childhood CVD risk factors?Q2: Is the association (Q1) mediated by childhood adiposity?
Childhood CVD risk factors
known association
known association?
SEP = socioeconomic positionCVD = cardiovascular diseaseT2D = type 2 diabetes
?
AgeBirth 10 years Adulthood