BMC Public Health 2008, 8:126 http://www.biomedcentral.com/1471-2458/8/126 Glasgow is a particularly appropriate setting for a study of the effects of deprivation on ill-health because of the strong socioeconomic gradient within the conurbation, the fact that deprived communities make up a substantial proportion of the population and the associated variation in mortality and morbidity[7]. The present study is to determine the extent to which the syndrome of central obesity/chronic inflammation explains the socioeco- nomic gradient in vascular disease and whether the syn- drome is associated with alterations in the mental state. Methods Aims and Hypotheses The study for the most part was an exploratory pilot for a large scale investigation of the genotypic and phenotypic determinants of ill health in deprived communities The overall aim was to determine the extent to which the linked syndrome of central obesity/chronic inflammation explains the social gradient in vascular disease and whether the syndrome is associated with alterations in the mental state. The hypotheses to be tested were summarised as follows in the study protocol: "Socioeconomic gradients in health are influenced by adverse environmental conditions, work, relationships, community, knowledge and practice of health-promoting or health-damaging behaviours. Hormonal and meta- bolic responses to the above stressors, while protective in the short term, in the long term causes adverse changes (e.g. hyperplasia of visceral adipose tissue and central obesity) that leads to chronic disease (e.g. atherosclero- sis). Further consequences are a heightened response to stress and a tendency towards depression and altered mental function". Research questions The following questions were addressed: 1) Do deprived sections of the community display increased prevalence of features of a condition termed metabolic syndrome (i.e. central obesity and insulin resistance) and chronic inflammation compared to afflu- ent sections? 2) Do deprived groups exhibit higher levels of serum endotoxin, revealing increased exposure to bacterial path- ogens (as a result for example of damp housing) com- pared to affluent groups? 3) Do deprived groups differ from affluent ones in psy- chological profile (affective state and cognition) and to what extent can this be related to the presence of the cen- tral obesity/insulin resistance/chronic inflammation syn- drome? 4) Is sub-clinical atherosclerosis (as detected by carotid ultrasound analysis) more prevalent in deprived groups? To what extent is the prevalence explained by classical risk factors (smoking, blood pressure, cholesterol) and to what extent is it related to the presence of metabolic syn- drome? In addition, we sought to ascertain the feasibility of a large scale population study by determining response rate, drop out rate, time taken by respondents to complete the ques- tionnaires and the visits, any discomfort experienced by respondents to the various medical assessments, numbers volunteering for the Magnetic Resonance Imaging (MRI) Scan etc, and how the above were affected by age group, sex and deprivation category. Ethical approval and confidentiality Ethical approval for the study was obtained from Glasgow Royal Infirmary Research Ethics committee. In all study records (electronic and paper) subjects were identified only by their study number. Information linking identity (name, address, general practitioners) to study number was held securely by the Glasgow Centre for Population Health[36] (GCPH; the coordinating centre). Only ano- nymised data were obtained from General Practice Administration System for Scotland[37] (GPASS) records on practice computers. The Health Board's Caldicott Guardian approved the study process and GPs with the approval of the ethics committee consented to the use of Community Health Index[38] and anonymised GPASS data. The Health Information and Technology (HIT) section of the Greater Glasgow Health Board (GGHB) was responsi- ble for sample selection and assignment of a study number to each subject (from 0001 to 3,600). Subjects Selection was based on the Scottish Index for Multiple Deprivation[39] (SIMD) which identified the least and most deprived areas in the Glasgow conurbation area. Five general practitioners (GP) practices with the highest percentage of patients aged 35–64 years living in areas classified as being in the bottom 5% of SIMD [most deprived (MD)] were approached and all agreed to partic- ipate in the recruitment process. A further five practices with the highest percentage of patients aged 35–64 years living in areas classified as being in the top 20% of SIMD [least deprived (LD)] also agreed to participate. HIT generated a target population of 21,672 people from the GP lists of these ten practices (Table 1). From this tar- Page 3 of 11 (page number not for citation purposes)