Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Education and incident type 2 diabetes: quantifying the impact of differential exposure and susceptibility to being overweight or obese

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Gut microbiota profile and selected plasma metabolites in type 1 diabetes without and with stratification by albuminuria

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Major decreases in the lipidome following liraglutide treatment: 21-25 September 2020.

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  3. Metabolites of the mitochondrial energy production are associated with future cardiovascular morbidity and mortality in type 1 diabetes

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  1. A prediction model for end-stage kidney disease in type 1 diabetes in the presence of competing risk of death

    Publikation: KonferencebidragKonferenceabstrakt til konferenceFormidling

  2. Discontinuation of diabetes medication in the 10 years before death: a nationwide register-based study: 21-25 September 2020.

    Publikation: KonferencebidragKonferenceabstrakt til konferenceForskningpeer review

  3. Is there a need for improving quality of diabetes care and diabetes support among individuals with coexisting diabetes and severe mental illness?

    Publikation: KonferencebidragKonferenceabstrakt til konferenceForskningpeer review

Vis graf over relationer

AIMS/HYPOTHESIS: Educational inequality in type 2 diabetes incidence is evident in many high-income countries. Previous studies have shown that differential exposure to being overweight/obese across educational groups may partly explain this inequality. Whether differential susceptibility to being overweight/obese across educational groups contributes to this inequality has been investigated less frequently, even though it is a plausible mechanism. The two mechanisms may even be highly intertwined. In this longitudinal cohort study, we investigated the simultaneous contribution of differential exposure and differential susceptibility to being overweight/obese to educational inequality in type 2 diabetes incidence.

METHODS: The study population comprised 53,159 Danish men and women aged 50-64 years at baseline who were followed for a mean of 14.7 years. We estimated rate differences of type 2 diabetes by education level per 100,000 person-years. Using counterfactual mediation analysis, these rate differences were decomposed into proportions attributable to differential exposure, differential susceptibility and all other pathways, respectively. We compared this approach with conventional approaches to mediation and interaction analysis.

RESULTS: Compared with a high level of education, a low education level was associated with 454 (95% CI 398, 510) additional cases of type 2 diabetes, and a medium education level with 316 (CI 268, 363) additional cases. Differential exposure to being overweight/obese accounted for 37% (CI 31%, 45%) of the additional cases among those with a low education level and 29% (CI 24%, 36%) of the additional cases among those with a medium education level. Differential susceptibility accounted for 9% (CI 4%, 14%) and 6% (CI 3%, 10%) of the additional cases among those with a low and medium education level, respectively. Compared with the counterfactual approach, the conventional approaches suggested stronger effects of both mechanisms.

CONCLUSIONS/INTERPRETATION: Differential exposure and susceptibility to being overweight/obese are both important mechanisms in the association between education and type 2 diabetes incidence.

OriginalsprogEngelsk
TidsskriftDiabetologia
Vol/bind63
Udgave nummer9
Sider (fra-til)1764-1774
Antal sider11
ISSN0012-186X
DOI
StatusUdgivet - 1 sep. 2020

ID: 59778054