Boffetta, P

Brenner, Herman

Kee, Frank

Kouvonen, Anne Maria

Marshall, Adele M

Mons, U

O'Doherty, Mark G

Saum, K U

Schottker, Ben

Steele, Christopher

Trichopoulou , A

BMJ Open

Objective: The study aims to identify the mediating factors of the relationship between education achievement and incident type 2 diabetes mellitus (T2DM) in older adults. Design: Population-based cohort study. Setting Participants were recruited from the German federal state of Saarland. Participants: Participants were excluded if they had prevalent T2DM or missing data on prevalent T2DM, missing or zero follow-up time for incident T2DM or were under 50 years of age. The total sample consisted of 7462 individuals aged 50-75 years (42.8% men, mean age 61.7 years) at baseline (2000-02). The median follow-up time was 8.0 years. Methods: Cox proportional hazards regression was initially used to determine the direct association between education achievement and incident T2DM. Using the Baron and Kenny approach, we then investigated the associations between education achievement and incident T2DM with the potential mediators. The contribution of each of the putative mediating variables was then calculated. Results: A clear socioeconomic gradient was observed with regard to T2DM incidence with the lowest educated individuals at a greater risk of developing the disease during the follow-up period: HR (95% CI) high education: 0.52 (0.34 to 0.80); medium education: 0.80 (0.66 to 0.96). Seven of the variables considered explained a proportion of the education-T2DM relationship (body mass index, alcohol consumption, hypertension, fasting triglycerides, high-density lipoprotein (HDL) cholesterol, physical activity and smoking status), where the contribution of the variables ranged from 1.0% to 17.7%. Overall, the mediators explained 31.7% of the relationship. Conclusion: By identifying the possible mediating factors of the relationship between education achievement and incident T2DM in older adults, the results of this study can be used to assist with the development of public health strategies that aim to reduce socioeconomic inequalities in T2DM. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved

Steele, C. J.

Schöttker, B.

Marshall, A. H.

Kouvonen, A.

O'Doherty, M. G.

Mons, U.

Saum, K. -U.

Boffetta, P.

Trichopoulou, A.

Brenner, H.

Kee, F.

Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

Education achievement and type 2 diabetes - What mediates the relationship in older adults? Data from the ESTHER study: A population-based cohort study

OBJECTIVE: The study aims to identify the mediating factors of the relationship between education achievement and incident type 2 diabetes mellitus (T2DM) in older adults.DESIGN: Population-based cohort study.SETTING: Participants were recruited from the German federal state of Saarland.PARTICIPANTS: Participants were excluded if they had prevalent T2DM or missing data on prevalent T2DM, missing or zero follow-up time for incident T2DM or were under 50 years of age. The total sample consisted of 7462 individuals aged 50-75 years (42.8% men, mean age 61.7 years) at baseline (2000-02). The median follow-up time was 8.0 years.METHODS: Cox proportional hazards regression was initially used to determine the direct association between education achievement and incident T2DM. Using the Baron and Kenny approach, we then investigated the associations between education achievement and incident T2DM with the potential mediators. The contribution of each of the putative mediating variables was then calculated.RESULTS: A clear socioeconomic gradient was observed with regard to T2DM incidence with the lowest educated individuals at a greater risk of developing the disease during the follow-up period: HR (95% CI) high education: 0.52 (0.34 to 0.80); medium education: 0.80 (0.66 to 0.96). Seven of the variables considered explained a proportion of the education-T2DM relationship (body mass index, alcohol consumption, hypertension, fasting triglycerides, high-density lipoprotein (HDL) cholesterol, physical activity and smoking status), where the contribution of the variables ranged from 1.0% to 17.7%. Overall, the mediators explained 31.7% of the relationship.CONCLUSION: By identifying the possible mediating factors of the relationship between education achievement and incident T2DM in older adults, the results of this study can be used to assist with the development of public health strategies that aim to reduce socioeconomic inequalities in T2DM.</p

Steele, Christopher J

Schöttker, Ben

Marshall, Adele H

Kouvonen, Anne

Mons, Ute

Saum, Kai-Uwe

Boffetta, Paolo

Trichopoulou, Antonia

Brenner, Hermann

Queen's University Belfast Research Portal

Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study: a population-based cohort study

Helsingin yliopiston digitaalinen arkisto

Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study : a population-based cohort study

Christopher J Steele

Ben Schöttker

Adele H Marshall

Anne Kouvonen

Mark G O'Doherty

Ute Mons

Kai-Uwe Saum

Paolo Boffetta

Antonia Trichopoulou

Hermann Brenner

Frank Kee

Crossref

Education achievement and type 2 diabetes—what mediates the relationship in older adults? Data from the ESTHER study: a population-based cohort study

Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study : a population-based cohort study

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Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

Queen's University Belfast Research Portal

Queen's University Belfast Research Portal

Helsingin yliopiston digitaalinen arkisto

Crossref