Socioeconomic position and the incidence of type 2 diabetes: the ELSA study
Socioeconomic position and the incidence of type 2 diabetes: the ELSA study
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DOI：
10.1007/s10654-012-9688-4
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发表时间：
2012-05-01
影响因子：
13.6
通讯作者：
Steptoe, Andrew
中科院分区：
文献类型：
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作者：
Demakakos, Panayotes;Marmot, Michael;Steptoe, Andrew
我们对英国老龄化纵向研究（艾尔莎）中7,432名50岁或以上的人进行了儿童和成人社会经济地位（SEP）与糖尿病发病率之间的相关性研究。在5.3年的随访中，我们分别确定了174例男性和189例女性糖尿病患者。估计了考克斯模型。在女性中，儿童SEP、教育、职业阶层、收入、财富和主观社会地位（SSS）与糖尿病事件有关。职业类别，收入和SSS并没有保持显着相关的事件糖尿病调整后的个人集的协变量（即不健康的行为，肥胖，或心理社会因素）。财富（HR：1.65，95% CI：1.05，2.60，最贫穷与最富有的三分位数）在调整所有协变量后仍与糖尿病事件显著相关，但教育（HR：1.46，95% CI：0.92，2.33，最低与最高类别）和儿童SEP（HR：1.47，95% CI：0.98，2.19，最低与最高类别）没有。在男性中，只有财富和SSS与糖尿病事件有关。在调整所有协变量后，SSS仍与糖尿病事件显著相关（HR：2.46，95% CI：1.32，4.68，最低与最高类别），但财富与此无关（HR：1.42，95% CI：0.94，2.15，最贫穷与最富有三分位数）。对财富的额外调整并没有对男性糖尿病和SSS之间的关联产生很大影响。老年妇女的糖尿病发病率与所有生命阶段的SEP相关，而老年男性仅与当前的SEP相关。心理社会因素（女性）、不健康行为和肥胖部分介导了这些关联。
We examined the associations between childhood and adult socioeconomic position (SEP) and incident diabetes in 7,432 individuals aged 50 or older from the English Longitudinal Study of Ageing (ELSA). We identified 174 and 189 cases of incident diabetes, in men and women, respectively, over 5.3 years of follow-up. Cox models were estimated. In women, childhood SEP, education, occupational class, income, wealth, and subjective social status (SSS) were related to incident diabetes. Occupational class, income, and SSS did not remain significantly related to incident diabetes after adjustment for individual sets of covariates (i.e. unhealthy behaviours, obesity, or psychosocial factors). Wealth (HR: 1.65, 95 % CI: 1.05, 2.60, poorest vs. wealthiest tertile) remained significantly related to incident diabetes after adjustment for all covariates, but education (HR: 1.46, 95 % CI: 0.92, 2.33, lowest vs. highest category) and childhood SEP (HR: 1.47, 95 % CI: 0.98, 2.19, lowest vs. highest category) did not. In men, only wealth and SSS were related to incident diabetes. SSS remained significantly related to incident diabetes after adjustment for all covariates (HR: 2.46, 95 % CI: 1.32, 4.68, lowest vs. highest category), but wealth did not (HR: 1.42, 95 % CI: 0.94, 2.15, poorest vs. wealthiest tertile). Additional adjustment for wealth did not greatly affect the association between incident diabetes and SSS in men. Incident diabetes in older women is associated with SEP from all life stages, while in older men only with current SEP. Psychosocial factors (in women), unhealthy behaviours, and obesity partly mediate these associations.