肥胖在男性和女性中使教育和糖尿病之间的相反关联成为可能：来自 REACTION 研究的结果。

Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study.

机构信息

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumors, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

J Diabetes. 2022 Nov;14(11):739-748. doi: 10.1111/1753-0407.13325. Epub 2022 Oct 11.

DOI:10.1111/1753-0407.13325

PMID:36217863

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9705800/

Abstract

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 (β[SE] 0.0387 [0.0037]) and negative in women (β[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.

摘要

背景

在发展中国家，有关教育对糖尿病风险影响的证据很少。我们旨在探讨中国庞大人群中教育与糖尿病之间的关系，并确定它们之间可能的中介因素。

方法

通过问卷收集教育水平和生活方式因素的信息。糖尿病的诊断依据是自我报告和生化测量。构建结构方程模型来量化每个中介因素的中介效应。

结果

与受教育程度最低的人相比，具有大学学历的男性患糖尿病的风险更高（优势比 [OR] 1.19；95%置信区间 [CI]，1.12-1.27），而具有大学学历的女性患糖尿病的风险较低（OR 0.77；95%CI，0.73-0.82）。肥胖是两性中最强的中介因素（中介比例：男性为 11.6%，女性为 23.9%），其与教育的关系在男性中呈正相关（β[SE] 0.0387 [0.0037]），而在女性中呈负相关（β[SE] -0.0824 [0.0030]）。综合来看，所有行为因素解释了男性糖尿病风险过高的 12.4%和女性糖尿病风险过高的 33.3%。