High levels of education are associated with an increased risk of latent autoimmune diabetes in adults: results from the Nord-Trøndelag health study.

Abstract:

OBJECTIVE:To investigate whether the risk for autoimmune diabetes in adults differs between socioeconomic groups and to compare such risk with that for type 2 diabetes. RESEARCH DESIGN AND METHODS:The inhabitants of the Norwegian county of Nord-Trøndelag were investigated by questionnaires and clinical examinations on three occasions during 1984-2008. We used information from a subset consisting of 56,296 subjects (participating in at least two surveys), including 122 incident cases of autoimmune diabetes in adults (aged ≥35 and anti-GAD positive) and 1,555 cases of type 2 diabetes (aged ≥35 and anti-GAD negative). Hazard ratios (HRs) of diabetes associated with self-reported education and occupation were estimated by Cox proportional hazards models. RESULTS:High levels of education (university versus primary school) were associated with an increased risk of autoimmune diabetes (HR 1.98 [95% CI 1.21-3.26]), after adjustment for BMI, lifestyle factors, and family history of diabetes. Case subjects with high levels of education had lower levels of C-peptide, tended to have higher levels of anti-GAD, and were more often treated with insulin. Conversely, these subjects had a reduced risk of type 2 diabetes (HR 0.69 [95% CI 0.57-0.82]), a risk that was partly explained by lower BMI and more physical activity (adjusted HR 0.89 [95% CI 0.74-1.06]). CONCLUSIONS:High levels of education are associated with an increased risk of autoimmune diabetes in adults, a finding that may be mediated by effects on autoimmune activity. Because the association is not explained by traditional risk factors, other, currently unidentified, environmental factors are likely to be involved.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Olsson L,Ahlbom A,Grill V,Midthjell K,Carlsson S

doi

10.2337/dc10-1061

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

102-7

issue

1

eissn

0149-5992

issn

1935-5548

pii

dc10-1061

journal_volume

34

pub_type

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