Article Text

Download PDFPDF
Childhood socioeconomic conditions are associated with increased chronic low-grade inflammation over adolescence: findings from the EPITeen cohort study
  1. Sílvia Fraga1,2,
  2. Milton Severo1,2,
  3. Elisabete Ramos1,2,
  4. Michelle Kelly-Irving3,4,
  5. Susana Silva1,2,
  6. Ana Isabel Ribeiro1,
  7. Dusan Petrovic5,
  8. Henrique Barros1,2,
  9. Silvia Stringhini5,6
  1. 1 EPIUnit- Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
  2. 2 Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  3. 3 INSERM, UMR 1027, Toulouse, France
  4. 4 Université Toulouse III Paul-Sabatier, UMR1027, Tolouse, France
  5. 5 UNISANTE, Départment d’Épidémiologie et Systems de Santé, Lausanne, Switzerland
  6. 6 Population Epidemiology Unit, Primary Care Division, Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to Dr Sílvia Fraga, Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal; silfraga{at}


Objective Early life adversity has been associated with increased risk of inflammation and inflammation-related diseases in adulthood. This study aimed to examine the association of childhood socioeconomic conditions with chronic low-grade inflammation over adolescence.

Methods We used information on 2942 members (1507 girls and 1435 boys) of the EPITeen (Epidemiological Health Investigation of Teenagers in Porto) cohort that was established in 2003 in Porto, Portugal, and included 13-year-old adolescents were further evaluated at 17 and 21 years. Mother’ and father’s education and occupation were used as indicators of childhood socioeconomic conditions. High-sensitivity C reactive protein (hs-CRP) was measured at three points in time (13, 17 and 21 years). hs-CRP levels were categorised in tertiles separately for each wave; chronic low-grade inflammation in adolescence was defined as having hs-CRP levels in the highest tertile in at least two waves and never in the lowest tertile.

Results Prevalence of chronic low-grade inflammation during adolescence was significantly higher among participants with low parental socioeconomic position. Low parental socioeconomic position was associated with chronic low-grade inflammation in adolescence, after adjustment for sex, perinatal and physical environment factors, health-related behaviours and health status in adolescence OR=1.6; 95% CI: 1.1 to 2.4 for lowest versus highest mother’s education and OR=1.6; 95% CI: 1.1 to 2.3 for lowest versus highest father’s occupation.

Conclusion Low childhood socioeconomic conditions are associated with chronic low-grade inflammation during adolescence. Our results suggest that the early life socioeconomic environment has an impact on inflammatory processes over adolescence.

  • adolescent health
  • epidemiology

Statistics from


  • Contributors SF conceptualised the study, performed initial data analysis, drafted the manuscript, revised the manuscript and approved the final manuscript as submitted. MS performed statistical analysis of the data, reviewed the manuscript and approved the final manuscript. ER and HB coordinated and supervised data collection, reviewed the manuscript and approved the final manuscript. MK-I, SuS, AIR, DP critically reviewed and approved the final manuscript. SiS conceptualised the study, reviewed the manuscript and approved the final manuscript as submitted.

  • Funding The study was supported by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology – FCT under the project 'BioAdversity: How childhood social adversity shapes health: The biology of social adversity' (Ref. FCT PTDC/DTP-EPI/1687/2014; POCI-01-0145-FEDER- 016838), and under the project 'When do health inequalities start? Understanding the impact of childhood social adversity on health trajectories from birth to early adolescence' (Ref. FCT PTDC/SAU-PUB/29567/2017; POCI-01-0145-FEDER-029567). Support was obtained from the Epidemiology Research Unit (Ref. UID/DTP/04750/2019; POCI-01-0145-FEDER-006862) and the FCT Investigator contract CEECIND/01516/2017/CP1406/CT0001 (to SF), co-funded by the FCT and the Human Capital Operational Programme and European Social Fund - HCOP/ESF Programme. We also received support from the LIFEPATH project funded by the European Commission (Horizon 2020 grant n° 633666) and from the University of Lausanne (Pro-Femmes grant – to SiS).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data used in this study came from the EPITeen Cohort. The dataset analysed during the current study are available from the Cohort Coordination (ER,, on reasonable request.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Atoms
    Nick Brown