University of Oulu

Oliver Robinson, Alice R Carter, Mika Ala-Korpela, Juan P Casas, Nishi Chaturvedi, Jorgen Engmann, Laura D Howe, Alun D Hughes, Marjo-Riitta Järvelin, Mika Kähönen, Ville Karhunen, Diana Kuh, Tina Shah, Yoav Ben-Shlomo, Reecha Sofat, Chung-Ho E Lau, Terho Lehtimäki, Usha Menon, Olli Raitakari, Andy Ryan, Rui Providencia, Stephanie Smith, Julie Taylor, Therese Tillin, Jorma Viikari, Andrew Wong, Aroon D Hingorani, Mika Kivimäki, Paolo Vineis, Metabolic profiles of socio-economic position: a multi-cohort analysis, International Journal of Epidemiology, Volume 50, Issue 3, June 2021, Pages 768–782,

Metabolic profiles of socio-economic position : a multi-cohort analysis

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Author: Robinson, Oliver1; Carter, Alice R.2; Ala-Korpela, Mika3,4,5,6;
Organizations: 1Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
2MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK
3Systems Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
4Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
5NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
6Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
7Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
8Division of Aging, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
9MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, UK
10Institute of Cardiovascular Science, University College London, UK
11Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
12Biocenter Oulu, University of Oulu, Oulu, Finland
13Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
14Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
15Department of Clinical Physiology, Tampere University Hospital, Finnish Cardiovascular Research Center—Tampere, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
16Institute of Health Informatics, University College London , London, UK
17Division of Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
18Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center—Tampere, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
19MRC Clinical Trials Unit at UCL, University College London, UK
20Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
21Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
22Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
23Institute of Health Informatics, University College London, London, UK
24Department of Medicine, University of Turku, (and) Division of Medicine, Turku University Hospital, Turku, Finland
25Health Data Research UK, London, UK
26University College London British Heart Foundation Research Accelerator, UK
27Department of Epidemiology and Public Health, University College London, London, UK
Format: article
Version: published version
Access: open
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Language: English
Published: Oxford University Press, 2021
Publish Date: 2021-05-04


Background: Low socio-economic position (SEP) is a risk factor for multiple health outcomes, but its molecular imprints in the body remain unclear.

Methods: We examined SEP as a determinant of serum nuclear magnetic resonance metabolic profiles in ∼30 000 adults and 4000 children across 10 UK and Finnish cohort studies.

Results: In risk-factor-adjusted analysis of 233 metabolic measures, low educational attainment was associated with 37 measures including higher levels of triglycerides in small high-density lipoproteins (HDL) and lower levels of docosahexaenoic acid (DHA), omega-3 fatty acids, apolipoprotein A1, large and very large HDL particles (including levels of their respective lipid constituents) and cholesterol measures across different density lipoproteins. Among adults whose father worked in manual occupations, associations with apolipoprotein A1, large and very large HDL particles and HDL-2 cholesterol remained after adjustment for SEP in later life. Among manual workers, levels of glutamine were higher compared with non-manual workers. All three indicators of low SEP were associated with lower DHA, omega-3 fatty acids and HDL diameter. At all ages, children of manual workers had lower levels of DHA as a proportion of total fatty acids.

Conclusions: Our work indicates that social and economic factors have a measurable impact on human physiology. Lower SEP was independently associated with a generally unfavourable metabolic profile, consistent across ages and cohorts. The metabolites we found to be associated with SEP, including DHA, are known to predict cardiovascular disease and cognitive decline in later life and may contribute to health inequalities.

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Series: International journal of epidemiology
ISSN: 0300-5771
ISSN-E: 1464-3685
ISSN-L: 0300-5771
Issue: 50
Pages: 768 - 782
DOI: 10.1093/ije/dyaa188
Type of Publication: A1 Journal article – refereed
Field of Science: 1184 Genetics, developmental biology, physiology
Funding: O. Robinson was supported by a Medical Research Council Early Career Fellowship and a UK Research and Innovation Future Leaders Fellowship (MR/S03532X/1). This research was supported by the ‘Lifepath’ (Grant ref 633666) and ‘STOP’ (Grant ref 774548) grants from the European Commission, and by the University College London British Heart Foundation Research Accelerator AA/18/6/34223 and British Heart Foundation Programme and Special Project Grants (RG/10/12/28456 and SP/13/6/30554). Infrastructure support for the Department of Epidemiology and Biostatistics, Imperial College London, was provided by the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre. This work was part supported by the MRC Centre for Environment and Health, which is currently funded by the Medical Research Council (MR/S019669/1, 2019–2024). The UK Medical Research Council and Wellcome (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. The BWHHS was funded by the Department of Health at baseline, and subsequently by British Heart Foundation from 2006 to 2017. The Young Finns Study has been financially supported by the Academy of Finland: grants 322098, 286284, 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117787 (Gendi) and 41071 (Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research; Finnish Cultural Foundation; The Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjö Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; EU Horizon 2020 (grant 755320 for TAXINOMISIS); European Research Council (grant 742927 for MULTIEPIGEN project); and Tampere University Hospital Supporting Foundation. The SABRE Study metabolomics analyses were supported by Diabetes UK (13/0004774). The SABRE Study was funded at baseline by the UK Medical Research Council, Diabetes UK and the British Heart Foundation, and at follow-up by the Wellcome Trust (082464/Z/07/Z) and British Heart Foundation (SP/07/001/23603, PG/08/103, PG/12/29/29497 and CS/13/1/30327). A.D.H. is a NIHR senior investigator and receives support from the NIHR University College London Hospitals Biomedical Research Centre. A.R.C. is supported by an MRC Integrative Epidemiology PhD studentship (MC_UU_00011/1). A.R.C. and L.H. both work in a unit that receives core funding from the MRC and University of Bristol (MC_UU_00011/1 and MC_UU_00011/6). L.D.H. is supported by an MRC Career Development Award (MR/M020894/1). D.K. and A.W. were supported by the UK Medical Research Council (MC_UU_00019/1), which provides core funding for the Medical Research Council National Survey of Health and Development. M.A.-K. is supported by a Senior Research Fellowship from the National Health and Medical Research Council of Australia (APP1158958). The Baker Institute is supported in part by the Victorian government’s Operational Infrastructure Support Program. M.A.-K. also holds a research grant from the Sigrid Juselius Foundation, Finland. M. Kivimäki was supported by the UK Medical Research Council (K013351, R024227, S011676), the US National Institute on Aging (NIH, R01AG056477), NordForsk, the Academy of Finland (311492) and Helsinki Institute of Life Science. The UKCTOCS Longitudinal Women’s Cohort and U.M. have received support from the National Institute for Health Research University College London Hospitals Biomedical Research Centre. R.S. is funded by the NIHR UCLH Biomedical Research Centre. NFBC1966 has received financial support from University of Oulu (Grants no. 24000692), Oulu University Hospital (Grant no. 24301140), ERDF European Regional Development Fund (Grant no. 539/2010 A31592), University of Oulu Grant no. 65354, Regional Institute of Occupational Health, Oulu, Finland (Grant no. 50621, 54231), the Academy of Finland (no. 104781, 120315, 129269, 1114194, 24300796, 85547), University Hospital Oulu, Biocenter, University of Oulu, Finland, the EU FP5 EURO-BLCS, QLG1-CT-2000–01643. The programme is currently being funded (for M.-R.J.) by the EU H2020-PHC-2014 DynaHEALTH action (No. 633595), EU H2020-HCO-2004 iHEALTH Action (No. 643774), EU H2020-SC1-2016–2017 LIFECYCLE Action (No. 733206), EU H2020-MSCA-ITN-2016 CAPICE Action (7215670), EU H2020 EUCAN-Connect Action (824989), EU H2020 EDCMET Action (No. 825762), EU H2020 LongITools (874739), Medical Research Council/Biotechnology and Biological Sciences Research Council (PREcisE, MR/M013138/1, MR/S03658X/1), under Nutrition & Epigenome, The Joint Programming Initiative a Healthy Diet for a Healthy Life (JPI HDHL/EU-H2020, project number 665) and Academy of Finland EGEA-project (285547). V.K. is funded by the EU 2020 research and innovation programme under the Marie Sklodowska-Curie grant (721567).
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(643774) iHealth-T2D - Family-based intervention to improve healthy lifestyle and prevent Type 2 Diabetes amongst South Asians with central obesity and prediabetes
(733206) LIFECYCLE - Early-life stressors and LifeCycle health
(824989) EUCAN-Connect - A federated FAIR platform enabling large-scale analysis of high-value cohort data connecting Europe and Canada in personalized health
(825762) EDCMET - Metabolic effects of Endocrine Disrupting Chemicals: novel testing METhods and adverse outcome pathways
(874739) LONGITOOLS - Dynamic longitudinal exposome trajectories in cardiovascular and metabolic non-communicable diseases
Academy of Finland Grant Number: 322098
Detailed Information: 322098 (Academy of Finland Funding decision)
285547 (Academy of Finland Funding decision)
129269 (Academy of Finland Funding decision)
114194 (Academy of Finland Funding decision)
Copyright information: © The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.