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Education, income, and obesity: A nationwide Chinese twin study.

AbstractOBJECTIVE:
This study aimed to examine the association of socioeconomic status with obesity.
METHODS:
A total of 39,262 twin individuals were included from the Chinese National Twin Registry (CNTR). Generalized estimating equation models for unmatched twin individual analyses and conditional logistic regression for the co-twin matched design were used. Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) was used to explore the evidence of a causal relationship.
RESULTS:
In general estimating equation models, high education level and income were associated with lower risk of obesity (odds ratio [OR] = 0.74 [95% CI: 0.65 to 0.84] and 0.86 [95% CI: 0.77 to 0.96]). In conditional logistic regression analysis, the association with education was significant (OR = 0.50 [95% CI: 0.34 to 0.74]) but the association with income was insignificant (OR = 0.74 [95% CI: 0.48 to 1.15]). From the ICE FALCON analysis, a twin's obesity was associated with the co-twin's education and income. After adjusting for the twin's own education, the association disappeared ( β co - twin '  = -0.10 [95% CI: -0.26 to 0.07]), whereas the twin's obesity was still associated with the co-twin's income but attenuated toward the null ( β co - twin '  = -0.21 [95% CI: -0.36 to -0.06]).
CONCLUSIONS:
Socioeconomic status is negatively associated with obesity. Education may have a causal effect on obesity, whereas the association between income and obesity is confounded by familial factors.
AuthorsKe Zheng, Wenjing Gao, Weihua Cao, Jun Lv, Canqing Yu, Shengfeng Wang, Tao Huang, Dianjianyi Sun, Chunxiao Liao, Yuanjie Pang, Zengchang Pang, Min Yu, Hua Wang, Xianping Wu, Zhong Dong, Fan Wu, Guohong Jiang, Xiaojie Wang, Yu Liu, Jian Deng, Lin Lu, Liming Li
JournalObesity (Silver Spring, Md.) (Obesity (Silver Spring)) Vol. 30 Issue 4 Pg. 931-942 (04 2022) ISSN: 1930-739X [Electronic] United States
PMID35275605 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Twin Study)
Copyright© 2022 The Obesity Society.
Topics
  • Asian People
  • China (epidemiology)
  • Humans
  • Obesity (epidemiology)
  • Odds Ratio
  • Twins

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