Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study.

Abstract : To assess the contribution of modifiable risk factors to social inequalities in the incidence of type 2 diabetes when these factors are measured at study baseline or repeatedly over follow-up and when long term exposure is accounted for. Prospective cohort study with risk factors (health behaviours (smoking, alcohol consumption, diet, and physical activity), body mass index, and biological risk markers (systolic blood pressure, triglycerides and high density lipoprotein cholesterol)) measured four times and diabetes status assessed seven times between 1991-93 and 2007-09. Civil service departments in London (Whitehall II study). 7237 adults without diabetes (mean age 49.4 years; 2196 women). Incidence of type 2 diabetes and contribution of risk factors to its association with socioeconomic status. Over a mean follow-up of 14.2 years, 818 incident cases of diabetes were identified. Participants in the lowest occupational category had a 1.86-fold (hazard ratio 1.86, 95% confidence interval 1.48 to 2.32) greater risk of developing diabetes relative to those in the highest occupational category. Health behaviours and body mass index explained 33% (-1% to 78%) of this socioeconomic differential when risk factors were assessed at study baseline (attenuation of hazard ratio from 1.86 to 1.51), 36% (22% to 66%) when they were assessed repeatedly over the follow-up (attenuated hazard ratio 1.48), and 45% (28% to 75%) when long term exposure over the follow-up was accounted for (attenuated hazard ratio 1.41). With additional adjustment for biological risk markers, a total of 53% (29% to 88%) of the socioeconomic differential was explained (attenuated hazard ratio 1.35, 1.05 to 1.72). Modifiable risk factors such as health behaviours and obesity, when measured repeatedly over time, explain almost half of the social inequalities in incidence of type 2 diabetes. This is more than was seen in previous studies based on single measurement of risk factors.
Type de document :
Article dans une revue
BMJ / BMJ (CLINICAL RESEARCH ED); Br Med J; British Medical Journal; Brit Med J, 2011, 345, pp.e5452. 〈10.1136/bmj.e5452〉
Liste complète des métadonnées

Littérature citée [55 références]  Voir  Masquer  Télécharger

http://www.hal.inserm.fr/inserm-01148015
Contributeur : Pascale Sztajnbok <>
Soumis le : lundi 4 mai 2015 - 09:39:24
Dernière modification le : jeudi 26 octobre 2017 - 16:34:02
Document(s) archivé(s) le : lundi 14 septembre 2015 - 17:56:50

Fichier

Stringhini_BMJ_2012.pdf
Publication financée par une institution

Identifiants

Collections

Citation

Silvia Stringhini, Adam Tabak, Tasnime Akbaraly, Séverine Sabia, Martin Shipley, et al.. Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study.. BMJ / BMJ (CLINICAL RESEARCH ED); Br Med J; British Medical Journal; Brit Med J, 2011, 345, pp.e5452. 〈10.1136/bmj.e5452〉. 〈inserm-01148015〉

Partager

Métriques

Consultations de la notice

157

Téléchargements de fichiers

293