Life-course socioeconomic position and type 2 diabetes mellitus: The Framingham Offspring Study.

Pubmed ID: 21242301

Pubmed Central ID: PMC3032804

Journal: American journal of epidemiology

Publication Date: Feb. 15, 2011

Affiliation: Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada. bsmith@iwh.on.ca

MeSH Terms: Humans, Male, Adult, Female, Risk Factors, United States, Logistic Models, Middle Aged, Social Class, Educational Status, Incidence, Socioeconomic Factors, Time Factors, Diabetes Mellitus, Type 2, Social Mobility, Occupations

Grants: MOP81239, N01-HC-25195, N01HC25195, HOA80072

Authors: Loucks EB, Abrahamowicz M, Lynch JW, Almeida ND, Smith BT, Fox CS, Harper S

Cite As: Smith BT, Lynch JW, Fox CS, Harper S, Abrahamowicz M, Almeida ND, Loucks EB. Life-course socioeconomic position and type 2 diabetes mellitus: The Framingham Offspring Study. Am J Epidemiol 2011 Feb 15;173(4):438-47. Epub 2011 Jan 17.

Studies:

Abstract

Evidence is lacking on whether the duration and timing of low socioeconomic position (SEP) across a person's life course may be associated with incidence of type 2 diabetes mellitus (T2D). The authors' objectives were to investigate associations between cumulative SEP and the incidence of T2D in the Framingham Offspring Study (n = 1,893; 52% women; mean baseline age = 34 years). Pooled logistic regression analyses demonstrated that age-adjusted cumulative SEP was associated with T2D in women (for low vs. high cumulative SEP, odds ratio (OR) = 1.92, 95% confidence interval (CI): 1.08, 3.42). Age-adjusted analyses for young-adulthood SEP (7.85 for ≤12 vs. >16 years of education, OR = 2.84, 95% CI: 1.03), active professional life SEP (for laborer vs. professional/executive/supervisory/technical occupations, OR = 2.40, 95% CI: 1.05, 5.47), and social-mobility frameworks (for declining life-course SEP, OR = 2.99, 95% CI: 1.39, 6.44; for stable low vs. stable high life-course SEP, OR = 1.85, 95% CI: 1.02, 3.35) all demonstrated associations between low SEP and T2D incidence in women. No association was observed between childhood SEP and T2D in women for father's education (some high school or less vs. any postsecondary education, OR = 1.26, 95% CI: 0.72, 2.22). In men, there was little evidence of associations between life-course SEP and T2D incidence. These findings suggest that cumulative SEP is inversely associated with incidence of T2D in women, and that this association may be primarily due to the women's educational levels and occupations.