Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland, UK.
J Epidemiol Community Health. 2010 Nov;64(11):1022-4. doi: 10.1136/jech.2009.094664. Epub 2010 Jul 30.
Low socioeconomic status (SES) is associated with adverse cardiovascular risk factor patterns and poorer outcomes for people with diabetes.
A cross-sectional study was performed using data for 35,925 people with diagnosed diabetes in Scotland and an area-based measure of SES using linked hospital and population-based diabetes register records. Comparisons by quintile of SES were made before (with p values presented for trend across quintiles given below) and after adjusting for other factors using multivariable logistic regression.
People in the most deprived quintile were more likely than people in the most affluent quintile to have hospital records for diabetic kidney disease (2.4% vs 2.0%, p=0.049), diabetic ketoacidosis (3.5% vs 3.0%, p=0.11), hypoglycaemia (1.8% vs 1.4%, p=0.008), ischaemic heart disease (22% vs 17%, p<0.0001), stroke (6.8% vs 5.1%, p<0.0001) and peripheral arterial disease (4.1% vs 2.1%, p<0.0001). An independent effect of SES persisted for cardiovascular disease outcomes after adjusting for age and sex. There were minimal differences in disease management measures by SES.
Managing current risk factors equitably is unlikely to remove socioeconomic inequalities in diabetes-related outcomes. Measures of SES may be valuable in risk scores and in making valid comparisons of the quality of diabetes care.
低社会经济地位（SES）与心血管风险因素模式不良和糖尿病患者预后较差有关。
使用苏格兰有确诊糖尿病的 35925 人数据和基于区域的 SES 衡量标准（使用链接的医院和人群为基础的糖尿病登记记录）进行了一项横断面研究。在调整了其他因素后，使用多变量逻辑回归对 SES 五分位数进行了比较（下面给出了五分位数之间的趋势的 p 值）。
与最富裕五分位数的人相比，最贫困五分位数的人更有可能有糖尿病肾病的住院记录（2.4%对 2.0%，p=0.049）、糖尿病酮症酸中毒（3.5%对 3.0%，p=0.11）、低血糖（1.8%对 1.4%，p=0.008）、缺血性心脏病（22%对 17%，p<0.0001）、中风（6.8%对 5.1%，p<0.0001）和外周动脉疾病（4.1%对 2.1%，p<0.0001）。在调整年龄和性别后，SES 对心血管疾病结果仍有独立影响。SES 对疾病管理措施的差异很小。
公平管理当前的风险因素不太可能消除与糖尿病相关结果的社会经济不平等。SES 指标在风险评分和评估糖尿病护理质量方面可能具有价值。
