Background Evidence regarding the impact of education on diabetes risk is scarce in developing countries. We aimed to explore the association between education and diabetes within a large population in China and to identify the possible mediators between them. Methods Information on educational level and lifestyle factors was collected through questionnaires. Diabetes was diagnosed from self-report and biochemical measurements. A structural equation model was constructed to quantify the mediation effect of each mediator. Results Compared with their least educated counterparts, men with college education had a higher risk of diabetes (odds ratio [OR] 1.19; 95% confidence interval [CI], 1.12-1.27), while college-educated women were less likely to have diabetes (OR 0.77; 95% CI, 0.73-0.82). Obesity was the strongest mediator in both genders (proportion of mediation: 11.6% in men and 23.9% in women), and its association with education was positive in men (beta[SE] 0.0387 [0.0037]) and negative in women (beta[SE] -0.0824 [0.0030]). Taken together, all behavioral factors explained 12.4% of the excess risk of diabetes in men and 33.3% in women. Conclusions In a general Chinese population, the association between education level and diabetes was positive in men but negative in women. Obesity was the major mediator underlying the education disparities of diabetes risk, with a stronger mediation effect among women.
基金:
National Natural Science Foundation of China [81970728, 81930021, 81970691, 82170819, 21904084]; Shanghai Outstanding Academic Leaders Plan [20XD1422800]; Shanghai Medical and Health Development Foundation [DMRFP_I_01]; Clinical Research Plan of SHDC [SHDC2020CR3064B, SHDC2020CR1001A]; Clinical Research Project of Shanghai Municipal Health Commission [20214Y0002]; Science and Technology Committee of Shanghai [19411964200, 20Y11905100]
第一作者单位:[1]Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Dept Endocrine & Metab Dis,Sch Med, Shanghai 200025, Peoples R China[2]Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Key Lab Endocrine Tumors,Shanghai Natl C, State Key Lab Med Genom,Sch Med,Key Lab Endocrine, Shanghai 200025, Peoples R China
通讯作者:
通讯机构:[1]Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Dept Endocrine & Metab Dis,Sch Med, Shanghai 200025, Peoples R China[2]Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Key Lab Endocrine Tumors,Shanghai Natl C, State Key Lab Med Genom,Sch Med,Key Lab Endocrine, Shanghai 200025, Peoples R China
推荐引用方式(GB/T 7714):
Zhu Yuanyue,Hu Chunyan,Lin Lin,et al.Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study[J].JOURNAL OF DIABETES.2022,14(11):739-748.doi:10.1111/1753-0407.13325.
APA:
Zhu, Yuanyue,Hu, Chunyan,Lin, Lin,Wang, Shuangyuan,Lin, Hong...&Lu, Jieli.(2022).Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study.JOURNAL OF DIABETES,14,(11)
MLA:
Zhu, Yuanyue,et al."Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study".JOURNAL OF DIABETES 14..11(2022):739-748