Barbier Jeanne Marie, Amiguet Michael, Vaucher Julien, Lasserre Aurélie M, Clair Carole, Schwarz Joëlle
Department of Ambulatory Care, Unisanté, Lausanne, Vaud, Switzerland.
Department of Medicine, Division of internal medicine, Lausanne University Hospital, Lausanne, Vaud, Switzerland.
BMJ Public Health. 2024 Feb 7;2(1):e000472. doi: 10.1136/bmjph-2023-000472. eCollection 2024 Jun.
Type 2 diabetes is multifactorial and influenced by the intersection of gender-related variables and other determinants of health. The aim of this study was to highlight the intersectional social position of the participants and disentangle its role from administrative sex in predicting the development of type 2 diabetes.
Using CoLaus|PsyCoLaus study, a Swiss single-centre prospective cohort initiated in 2003 and including 6733 participants (age 35-75 years; 54% women) at baseline, we conducted latent class analyses using gender-related variables (eg, risk-taking behaviours, gender roles represented by employment status, etc) and socioeconomic determinants at baseline (2003-2006) to construct intersectional classes and we tested their association with the development of type 2 diabetes at follow-up (2018-2021).
Of the 6733 participants enrolled at baseline, 3409 were included in our analyses (50.6%). Over a median follow-up time of 14.5 years, 255 (7.5%) participants developed type 2 diabetes, of which 158 men (62.0%). We identified seven latent classes highlighting different intersectional social position groups (ie, )). Using the class labelled as 'young, fit, educated men' as reference, the risk of incident type 2 diabetes was higher in all other classes (adjusted OR values between 4.22 and 13.47). Classes mostly feminine had a more unfavourable intersectional social position than that of the predominantly masculine classes. The corresponding OR increased in sex-adjusted regressions analyses.
We observe cumulative intersectional effects across behavioural and socioeconomic profiles with different risks of developing type 2 diabetes emphasising the deleterious effect of a feminine gender profile. These patterns are only partly captured by traditional sex-stratified analyses.
2型糖尿病是多因素的，受与性别相关变量及其他健康决定因素的交叉影响。本研究的目的是突出参与者的交叉社会地位，并在预测2型糖尿病发展时将其作用与行政性别区分开来。
利用CoLaus|PsyCoLaus研究，这是一项2003年启动的瑞士单中心前瞻性队列研究，基线时纳入6733名参与者（年龄35 - 75岁；54%为女性），我们使用与性别相关的变量（如冒险行为、以就业状况表示的性别角色等）和基线（2003 - 2006年）时的社会经济决定因素进行潜在类别分析，以构建交叉类别，并在随访（2018 - 2021年）时测试它们与2型糖尿病发展的关联。
在基线时纳入的6733名参与者中，3409名被纳入我们的分析（50.6%）。在中位随访时间14.5年期间，255名（7.5%）参与者患2型糖尿病，其中158名男性（62.0%）。我们确定了七个潜在类别，突出了不同的交叉社会地位群体（即 ）。以标记为“年轻、健康、受过教育的男性”的类别为参照，所有其他类别中2型糖尿病发病风险更高（调整后的OR值在4.22至13.47之间）。主要为女性的类别比主要为男性的类别具有更不利的交叉社会地位。在性别调整回归分析中，相应的OR增加。
我们观察到行为和社会经济特征方面存在累积交叉效应，不同的2型糖尿病发病风险强调了女性性别特征的有害影响。这些模式仅部分被传统的性别分层分析所捕捉。
