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International Journal of Epidemiology 2007 36(1):84-92; doi:10.1093/ije/dyl269
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.

Socio-economic position at three points in life in association with type 2 diabetes and impaired glucose tolerance in middle-aged Swedish men and women

EE Agardh1, A Ahlbom2,3, T Andersson3, S Efendic1, V Grill1, J Hallqvist4 and CG Östenson1,*

1Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden.
2Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
3Department of Epidemiology, Stockholm Center of Public Health, Stockholm, Sweden.
4Department of Public Health Science, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.

* Corresponding author. Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, SE 171 76 Stockholm, Sweden. E-mail: claes-goran.ostenson{at}karolinska.se


   Abstract

Background It has been suggested that low socio-economic position (SEP) during childhood and adolescence predicts risk of adult type 2 diabetes. We investigated the associations between type 2 diabetes and childhood SEP (fathers’ occupational position), participants’ education and adult SEP (participants’ occupational position). To determine possible independent associations between early SEP (fathers’ occupational position and participants’ education) and disease, we adjusted for adult SEP and factors present in adult life associated with type 2 diabetes.

Methods This cross-sectional study comprised 3128 men and 4821 women aged 35–56 years. All subjects have gone through a health examination and answered a questionnaire on lifestyle factors. At the health centre, an oral glucose tolerance test was administered and identified 55 men and 52 women with previously undiagnosed type 2 diabetes. Relative risks (RRs) with 95% CIs were calculated in multiple logistic regression analyses.

Results The age-adjusted RRs of type 2 diabetes if having a father with middle occupational position were 2.3 [Confidence interval (CI:1.0–5.1) for women and, 2.0 (CI:0.7–5.6) for men]. Moreover, low education was associated with type 2 diabetes in women, RR = 2.5 (CI:1.2–4.9). Low occupational position in adulthood was associated with type 2 diabetes in women, RR = 2.7 (CI:1.3–5.9) and men, RR = 2.9 (CI:1.5–5.7). The associations between early SEP and type 2 diabetes disappeared after adjustment for adult SEP and factors associated with type 2 diabetes.

Conclusion The association between type 2 diabetes and low SEP during childhood and adolescence in middle-aged Swedish subjects disappeared after adjustment for adult SEP and adult risk factors of diabetes.


Keywords Diabetes Mellitus, type 2, epidemiology, socioeconomic factors, lifestyle, childhood

Accepted 6 November 2006


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