PMID- 22736421
OWN - NLM
STAT- MEDLINE
DCOM- 20130211
LR  - 20220317
IS  - 1464-3685 (Electronic)
IS  - 0300-5771 (Linking)
VI  - 41
IP  - 4
DP  - 2012 Aug
TI  - Lower educational level is a predictor of incident type 2 diabetes in European 
      countries: the EPIC-InterAct study.
PG  - 1162-73
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) is one of the most common chronic 
      diseases worldwide. In high-income countries, low socioeconomic status seems to 
      be related to a high incidence of T2DM, but very little is known about the 
      intermediate factors of this relationship. Method We performed a case-cohort 
      study in eight Western European countries nested in the EPIC study (n = 340, 234, 
      3.99 million person-years of follow-up). A random sub-cohort of 16,835 
      individuals and a total of 12,403 incident cases of T2DM were identified. Crude 
      and multivariate-adjusted hazard ratios (HR) were estimated for each country and 
      pooled across countries using meta-analytical methods. Age-, gender- and 
      country-specific relative indices of inequality (RII) were used as the measure of 
      educational level and RII tertiles were analysed. RESULTS: Compared with 
      participants with a high educational level (RII tertile 1), participants with a 
      low educational level (RII tertile 3) had a higher risk of T2DM [HR: 1.77, 95% 
      confidence interval (CI): 1.69-1.85; P-trend < 0.01]. The HRs adjusted for 
      physical activity, smoking status and propensity score according to macronutrient 
      intake were very similar to the crude HR (adjusted HR: 1.67, 95% CI: 1.52-1.83 in 
      men; HR: 1.88, 95% CI: 1.73-2.05 in women). The HRs were attenuated only when 
      they were further adjusted for BMI (BMI-adjusted HR: 1.36, 95% CI: 1.23-1.51 in 
      men; HR: 1.32, 95% CI: 1.20-1.45 in women). CONCLUSION: This study demonstrates 
      the inequalities in the risk of T2DM in Western European countries, with an 
      inverse relationship between educational level and risk of T2DM that is only 
      partially explained by variations in BMI.
FAU - Sacerdote, Carlotta
AU  - Sacerdote C
AD  - Center for Cancer Prevention, CPO-Piemonte, Torino, Italy. 
      carlotta.sacerdote@cpo.it
FAU - Ricceri, Fulvio
AU  - Ricceri F
FAU - Rolandsson, Olov
AU  - Rolandsson O
FAU - Baldi, Ileana
AU  - Baldi I
FAU - Chirlaque, Maria-Dolores
AU  - Chirlaque MD
FAU - Feskens, Edith
AU  - Feskens E
FAU - Bendinelli, Benedetta
AU  - Bendinelli B
FAU - Ardanaz, Eva
AU  - Ardanaz E
FAU - Arriola, Larraitz
AU  - Arriola L
FAU - Balkau, Beverley
AU  - Balkau B
FAU - Bergmann, Manuela
AU  - Bergmann M
FAU - Beulens, Joline W J
AU  - Beulens JW
FAU - Boeing, Heiner
AU  - Boeing H
FAU - Clavel-Chapelon, Francoise
AU  - Clavel-Chapelon F
FAU - Crowe, Francesca
AU  - Crowe F
FAU - de Lauzon-Guillain, Blandine
AU  - de Lauzon-Guillain B
FAU - Forouhi, Nita
AU  - Forouhi N
FAU - Franks, Paul W
AU  - Franks PW
FAU - Gallo, Valentina
AU  - Gallo V
FAU - Gonzalez, Carlos
AU  - Gonzalez C
FAU - Halkjaer, Jytte
AU  - Halkjaer J
FAU - Illner, Anne-Kathrin
AU  - Illner AK
FAU - Kaaks, Rudolf
AU  - Kaaks R
FAU - Key, Timothy
AU  - Key T
FAU - Khaw, Kay-Tee
AU  - Khaw KT
FAU - Navarro, Carmen
AU  - Navarro C
FAU - Nilsson, Peter M
AU  - Nilsson PM
FAU - Dal Ton, Susanne Oksbjerg
AU  - Dal Ton SO
FAU - Overvad, Kim
AU  - Overvad K
FAU - Pala, Valeria
AU  - Pala V
FAU - Palli, Domenico
AU  - Palli D
FAU - Panico, Salvatore
AU  - Panico S
FAU - Polidoro, Silvia
AU  - Polidoro S
FAU - Quiros, J Ramon
AU  - Quiros JR
FAU - Romieu, Isabelle
AU  - Romieu I
FAU - Sanchez, Maria-Jose
AU  - Sanchez MJ
FAU - Slimani, Nadia
AU  - Slimani N
FAU - Sluijs, Ivonne
AU  - Sluijs I
FAU - Spijkerman, Annemieke
AU  - Spijkerman A
FAU - Teucher, Birgit
AU  - Teucher B
FAU - Tjonneland, Anne
AU  - Tjonneland A
FAU - Tumino, Rosario
AU  - Tumino R
FAU - van der A, Daphne
AU  - van der A D
FAU - Vergnaud, Anne-Claire
AU  - Vergnaud AC
FAU - Wennberg, Patrik
AU  - Wennberg P
FAU - Sharp, Stephen
AU  - Sharp S
FAU - Langenberg, Claudia
AU  - Langenberg C
FAU - Riboli, Elio
AU  - Riboli E
FAU - Vineis, Paolo
AU  - Vineis P
FAU - Wareham, Nicholas
AU  - Wareham N
LA  - eng
GR  - MC_UP_A100_1003/MRC_/Medical Research Council/United Kingdom
GR  - G1000143/MRC_/Medical Research Council/United Kingdom
GR  - MC_U106179471/MRC_/Medical Research Council/United Kingdom
GR  - G0401527/MRC_/Medical Research Council/United Kingdom
GR  - CRUK_/Cancer Research UK/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20120625
PL  - England
TA  - Int J Epidemiol
JT  - International journal of epidemiology
JID - 7802871
SB  - IM
MH  - Age Factors
MH  - Case-Control Studies
MH  - Demography
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - *Educational Status
MH  - Europe/epidemiology
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - Socioeconomic Factors
MH  - Surveys and Questionnaires
EDAT- 2012/06/28 06:00
MHDA- 2013/02/12 06:00
CRDT- 2012/06/28 06:00
PHST- 2012/06/28 06:00 [entrez]
PHST- 2012/06/28 06:00 [pubmed]
PHST- 2013/02/12 06:00 [medline]
AID - dys091 [pii]
AID - 10.1093/ije/dys091 [doi]
PST - ppublish
SO  - Int J Epidemiol. 2012 Aug;41(4):1162-73. doi: 10.1093/ije/dys091. Epub 2012 Jun 
      25.