Socioeconomic position, type 2 diabetes and long-term risk of death
Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account. We conducted a population-based cohort study o...
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| description | Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account.
We conducted a population-based cohort study of all Danish citizens aged 40-69 years with no history of diabetes during 2001-2006 (N=2,330,206). The cohort was identified using nationwide registers, and it was followed for up to 11 years (mean follow-up was 9.5 years (SD: 2.6)). We estimated the age-standardised mortality rate (MR) and performed Poisson regression to estimate the mortality-rate-ratio (MRR) by educational level, income and cohabiting status among people with and without type 2 diabetes.
We followed 2,330,206 people for 22,971,026 person-years at risk and identified 139,681 individuals with type 2 diabetes. In total, 195,661 people died during the study period; 19,959 of these had type 2 diabetes. The age-standardised MR increased with decreasing SEP both for people with and without diabetes. Type 2 diabetes and SEP both had a strong impact on the overall mortality; the combined effect of type 2 diabetes and SEP on mortality was additive rather than multiplicative. Compared to women without diabetes and in the highest income quintile, the MRR's were 2.8 (95%CI 2.6, 3.0) higher for women with type 2 diabetes in the lowest income quintile, while diabetes alone increased the risk of mortality 2.0 (95%CI 1.9, 2.2) times and being in the lowest income quintile without diabetes 1.8 (95%CI 1.7,1.9) times after adjusting for comorbidity. For men, the MRR's were 2.7 (95%CI 2.5,2.9), 1.9 (95%CI 1.8,2.0) and 1.8 (95%CI 1.8,1.9), respectively.
Both Type 2 diabetes and SEP were associated with the overall mortality. The relation between type 2 diabetes, SEP, and all-cause mortality was only partly explained by comorbidity. |
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We conducted a population-based cohort study of all Danish citizens aged 40-69 years with no history of diabetes during 2001-2006 (N=2,330,206). The cohort was identified using nationwide registers, and it was followed for up to 11 years (mean follow-up was 9.5 years (SD: 2.6)). We estimated the age-standardised mortality rate (MR) and performed Poisson regression to estimate the mortality-rate-ratio (MRR) by educational level, income and cohabiting status among people with and without type 2 diabetes.
We followed 2,330,206 people for 22,971,026 person-years at risk and identified 139,681 individuals with type 2 diabetes. In total, 195,661 people died during the study period; 19,959 of these had type 2 diabetes. The age-standardised MR increased with decreasing SEP both for people with and without diabetes. Type 2 diabetes and SEP both had a strong impact on the overall mortality; the combined effect of type 2 diabetes and SEP on mortality was additive rather than multiplicative. Compared to women without diabetes and in the highest income quintile, the MRR's were 2.8 (95%CI 2.6, 3.0) higher for women with type 2 diabetes in the lowest income quintile, while diabetes alone increased the risk of mortality 2.0 (95%CI 1.9, 2.2) times and being in the lowest income quintile without diabetes 1.8 (95%CI 1.7,1.9) times after adjusting for comorbidity. For men, the MRR's were 2.7 (95%CI 2.5,2.9), 1.9 (95%CI 1.8,2.0) and 1.8 (95%CI 1.8,1.9), respectively.
Both Type 2 diabetes and SEP were associated with the overall mortality. The relation between type 2 diabetes, SEP, and all-cause mortality was only partly explained by comorbidity.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0124829</identifier><identifier>PMID: 25942435</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age ; Aged ; Cancer ; Care and treatment ; Cause of Death ; Cohort analysis ; Comorbidity ; Complications and side effects ; Denmark - epidemiology ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - mortality ; Education ; Female ; Follow-Up Studies ; Health aspects ; Health risk assessment ; Health risks ; Humans ; Income ; Male ; Middle Aged ; Mortality ; Patient outcomes ; Poisson density functions ; Population ; Population studies ; Population Surveillance ; Public health ; Registration ; Registries ; Risk ; Risk factors ; Socioeconomic Factors ; Socioeconomics ; Statistical analysis ; Studies ; Type 2 diabetes</subject><ispartof>PloS one, 2015-05, Vol.10 (5), p.e0124829-e0124829</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Dalsgaard et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Dalsgaard et al 2015 Dalsgaard et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6fbab80734dde12329bf27281648525cc8a1d442c653ecb15584037d11a4047a3</citedby><cites>FETCH-LOGICAL-c692t-6fbab80734dde12329bf27281648525cc8a1d442c653ecb15584037d11a4047a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420496/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420496/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25942435$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dalsgaard, Else-Marie</creatorcontrib><creatorcontrib>Skriver, Mette V</creatorcontrib><creatorcontrib>Sandbaek, Annelli</creatorcontrib><creatorcontrib>Vestergaard, Mogens</creatorcontrib><title>Socioeconomic position, type 2 diabetes and long-term risk of death</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account.
We conducted a population-based cohort study of all Danish citizens aged 40-69 years with no history of diabetes during 2001-2006 (N=2,330,206). The cohort was identified using nationwide registers, and it was followed for up to 11 years (mean follow-up was 9.5 years (SD: 2.6)). We estimated the age-standardised mortality rate (MR) and performed Poisson regression to estimate the mortality-rate-ratio (MRR) by educational level, income and cohabiting status among people with and without type 2 diabetes.
We followed 2,330,206 people for 22,971,026 person-years at risk and identified 139,681 individuals with type 2 diabetes. In total, 195,661 people died during the study period; 19,959 of these had type 2 diabetes. The age-standardised MR increased with decreasing SEP both for people with and without diabetes. Type 2 diabetes and SEP both had a strong impact on the overall mortality; the combined effect of type 2 diabetes and SEP on mortality was additive rather than multiplicative. Compared to women without diabetes and in the highest income quintile, the MRR's were 2.8 (95%CI 2.6, 3.0) higher for women with type 2 diabetes in the lowest income quintile, while diabetes alone increased the risk of mortality 2.0 (95%CI 1.9, 2.2) times and being in the lowest income quintile without diabetes 1.8 (95%CI 1.7,1.9) times after adjusting for comorbidity. For men, the MRR's were 2.7 (95%CI 2.5,2.9), 1.9 (95%CI 1.8,2.0) and 1.8 (95%CI 1.8,1.9), respectively.
Both Type 2 diabetes and SEP were associated with the overall mortality. The relation between type 2 diabetes, SEP, and all-cause mortality was only partly explained by comorbidity.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Cause of Death</subject><subject>Cohort analysis</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Denmark - epidemiology</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Education</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Income</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Poisson density functions</subject><subject>Population</subject><subject>Population studies</subject><subject>Population Surveillance</subject><subject>Public health</subject><subject>Registration</subject><subject>Registries</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Socioeconomic Factors</subject><subject>Socioeconomics</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Type 2 diabetes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl2L1DAUhoso7rr6D0QLgig4Yz7b9EZYBj8GFhZc9TakyelMxk7TTVJx_72p012msheSi4ST57wnJ-fNsucYLTEt8fudG3yn2mXvOlgiTJgg1YPsFFeULAqC6MOj80n2JIQdQpyKonicnRBeMcIoP81WV05bB9p1bm913rtgo3Xduzze9JCT3FhVQ4SQq87kres2iwh-n3sbfuauyQ2ouH2aPWpUG-DZtJ9l3z99_Lb6sri4_LxenV8sdFGRuCiaWtUClZQZA5hQUtUNKYnABROccK2FwoYxogtOQdeYc8EQLQ3GiiFWKnqWvTzo9q0Lcuo_SFyUoiwJQSQR6wNhnNrJ3tu98jfSKSv_BpzfSOWj1S3IsZApWUG5EEzXpNJVJRqoKal5U9EmaX2Yqg31HoyGLnrVzkTnN53dyo37NSojVhVJ4M0k4N31ACHKvQ0a2lZ14Ibx3QJhUXIiEvrqH_T-7iZqo1IDtmtcqqtHUXnOKErT5gQnankPlZaBNOFklsam-Czh7SwhMRF-x40aQpDrq6__z17-mLOvj9gtqDZug2uH0V9hDrIDqL0LwUNz98kYydHrt78hR6_Lyesp7cXxgO6Sbs1N_wDYs_Zi</recordid><startdate>20150505</startdate><enddate>20150505</enddate><creator>Dalsgaard, Else-Marie</creator><creator>Skriver, Mette V</creator><creator>Sandbaek, Annelli</creator><creator>Vestergaard, Mogens</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150505</creationdate><title>Socioeconomic position, type 2 diabetes and long-term risk of death</title><author>Dalsgaard, Else-Marie ; Skriver, Mette V ; Sandbaek, Annelli ; Vestergaard, Mogens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-6fbab80734dde12329bf27281648525cc8a1d442c653ecb15584037d11a4047a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Cause of Death</topic><topic>Cohort analysis</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Denmark - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dalsgaard, Else-Marie</au><au>Skriver, Mette V</au><au>Sandbaek, Annelli</au><au>Vestergaard, Mogens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Socioeconomic position, type 2 diabetes and long-term risk of death</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-05-05</date><risdate>2015</risdate><volume>10</volume><issue>5</issue><spage>e0124829</spage><epage>e0124829</epage><pages>e0124829-e0124829</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account.
We conducted a population-based cohort study of all Danish citizens aged 40-69 years with no history of diabetes during 2001-2006 (N=2,330,206). The cohort was identified using nationwide registers, and it was followed for up to 11 years (mean follow-up was 9.5 years (SD: 2.6)). We estimated the age-standardised mortality rate (MR) and performed Poisson regression to estimate the mortality-rate-ratio (MRR) by educational level, income and cohabiting status among people with and without type 2 diabetes.
We followed 2,330,206 people for 22,971,026 person-years at risk and identified 139,681 individuals with type 2 diabetes. In total, 195,661 people died during the study period; 19,959 of these had type 2 diabetes. The age-standardised MR increased with decreasing SEP both for people with and without diabetes. Type 2 diabetes and SEP both had a strong impact on the overall mortality; the combined effect of type 2 diabetes and SEP on mortality was additive rather than multiplicative. Compared to women without diabetes and in the highest income quintile, the MRR's were 2.8 (95%CI 2.6, 3.0) higher for women with type 2 diabetes in the lowest income quintile, while diabetes alone increased the risk of mortality 2.0 (95%CI 1.9, 2.2) times and being in the lowest income quintile without diabetes 1.8 (95%CI 1.7,1.9) times after adjusting for comorbidity. For men, the MRR's were 2.7 (95%CI 2.5,2.9), 1.9 (95%CI 1.8,2.0) and 1.8 (95%CI 1.8,1.9), respectively.
Both Type 2 diabetes and SEP were associated with the overall mortality. The relation between type 2 diabetes, SEP, and all-cause mortality was only partly explained by comorbidity.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25942435</pmid><doi>10.1371/journal.pone.0124829</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Aged Cancer Care and treatment Cause of Death Cohort analysis Comorbidity Complications and side effects Denmark - epidemiology Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - mortality Education Female Follow-Up Studies Health aspects Health risk assessment Health risks Humans Income Male Middle Aged Mortality Patient outcomes Poisson density functions Population Population studies Population Surveillance Public health Registration Registries Risk Risk factors Socioeconomic Factors Socioeconomics Statistical analysis Studies Type 2 diabetes |
| title | Socioeconomic position, type 2 diabetes and long-term risk of death |
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