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A theoretical model analyzed the association among socioeconomic determinants, metabolic risk, asthma, and depression using Structural Equation Modeling (SEM).\n                      <jats:italic>Low Socioeconomic Status<\/jats:italic>\n                      was a distal determinant. The metabolic risk included the TG\/HDL ratio, as an insulin resistance marker, as well as obesity.\n                      <jats:italic>Asthma<\/jats:italic>\n                      was a latent variable based on wheezing, asthma history, medical diagnosis, and frequency of wheezing. Depression was diagnosed based on major and recurrent episodes using the M.I.N.I.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Low socioeconomic status<\/jats:italic>\n                      was associated with higher insulin resistance precursor (TG\/HDL ratio) (standardized coefficient, SC\u2009=\u20090.064;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.027) and with higher levels of depression (SC\u2009=\u20090.084;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001). Higher insulin resistance precursor was associated with\n                      <jats:italic>asthma<\/jats:italic>\n                      (SC\u2009=\u20090.069;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.042).\n                      <jats:italic>Asthma<\/jats:italic>\n                      was associated with depression (SC\u2009=\u20090.078;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Lower insulin resistance precursor levels were observed in girls (SC\u2009=\u2009\u22120.254;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001); meanwhile, obesity (SC\u2009=\u20090.124;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and depression (SC\u2009=\u20090.165;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) had higher values for them.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings underscore interconnected issues of low socioeconomic status, metabolic risk, asthma, and depression in adolescents. Recognizing the syndemic framework can lead to more effective health policies to prevent long\u2010term physical and mental health consequences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70290","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T03:25:16Z","timestamp":1771817116000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Low socioeconomic status, insulin resistance, asthma, and depression: A syndemic framework in Brazilian adolescents"],"prefix":"10.1111","volume":"37","author":[{"given":"Aline Sousa","family":"Falc\u00e3o","sequence":"first","affiliation":[{"name":"Graduate Program in Public Health Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena L\u00facia Costa","family":"Ladeira","sequence":"additional","affiliation":[{"name":"Graduate Program in Dentistry 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