Epidemiology Unit, ASL TO3, Via Sabaudia 164, Regione Piemonte, Grugliasco, TO, Italy.
Diabetes Res Clin Pract. 2011 May;92(2):205-12. doi: 10.1016/j.diabres.2011.02.011. Epub 2011 Mar 5.
We investigated if diabetes modifies the effect of the association of education with mortality and incidence of cardiovascular diseases.
We identified 44,889 diabetics using multiple data sources. They were followed up from January 2002 up to December 2005, and their mortality, incidence of myocardial infarction and stroke, by educational level were analysed, and compared with those of the local non-diabetic population.
The all-cause Standardized Mortality Ratios among diabetics, compared with non-diabetics, were 170 for men and 175 for women. Standardized Incidence Ratios were 199 for myocardial infarction, and 183 for stroke in men and, respectively, 281, and 179 in women. Among non-diabetics there was a clear inverse relation with educational level for all outcomes, whereas among diabetics no significant social difference in incidence was found; slight social differences in mortality were present among men, but not among women. The effect of diabetes on social differences was enhanced in the youngest population.
Diabetes increases the risk of death and the incidence of vascular diseases, but reduces their inverse association with education. This is likely related to the high accessibility and good quality of health care provided by the local networks of diabetic centres and primary care.
本研究旨在探讨糖尿病是否会改变教育程度与心血管疾病死亡率和发病率之间的关联。
我们使用多种数据源确定了 44889 名糖尿病患者。随访时间从 2002 年 1 月至 2005 年 12 月，分析了他们的死亡率、心肌梗死和中风发病率与受教育程度的关系，并与当地非糖尿病人群进行了比较。
与非糖尿病患者相比，糖尿病患者的全因标准化死亡率男性为 170，女性为 175。男性心肌梗死和中风的标准化发病率分别为 199 和 183，女性分别为 281 和 179。在非糖尿病患者中，所有结局都与教育程度呈明显的负相关关系，而在糖尿病患者中，发病率则没有明显的社会差异；男性的死亡率存在轻微的社会差异，但女性没有。糖尿病对社会差异的影响在年轻人群中更为明显。
糖尿病增加了死亡和血管疾病的发病风险，但降低了其与教育程度之间的负相关关系。这可能与当地糖尿病中心和初级保健网络提供的高可及性和高质量医疗保健有关。
